The PRISMA Project: Implementation screening and diagnosis Obstructive Sleep Apnea in primary care

The PRISMA Project, aimed at Screening and Managing Obstructive Sleep Apnea (OSA) in Primary Care, addresses the challenge of underdiagnosed OSA, a condition with high cardiovascular and quality-of-life implications for affected patients. The project is designed to integrate OSA screening and diagnostic processes into primary care, leveraging the use of home-based respiratory polygraphy (PR) for patients identified as having a moderate to high risk of OSA. Key aspects of the PRISMA Project include the use of the STOP-Bang questionnaire in primary care centers across the Balearic Islands. This tool aids in identifying patients likely to have OSA, who are then offered respiratory polygraphy as a more accessible alternative to standard hospital polysomnography (PSG). In cases where OSA is confirmed through PR, patients can be referred to sleep units for further assessment and potential initiation of continuous positive airway pressure (CPAP) therapy. The PRISMA Project aims to decrease the diagnostic delay for OSA, allow earlier intervention, and reduce the burden on specialized hospital sleep units. Initial findings from pilot studies indicate a high concordance rate between PR assessments conducted in primary care settings and PSG assessments performed in hospitals. This suggests that PR is a viable diagnostic alternative in primary care, allowing for a more decentralized and cost-effective approach to OSA management. Through this model, PRISMA highlights primary care's potential in the initial management of OSA and supports a more integrated and efficient pathway for OSA diagnosis and treatment. This project serves as a scalable example for other regions seeking to enhance primary care's role in managing respiratory diseases. Funding: Project financed with finalist funds from the Ministry of Health of the Government oof Spain to improve the resolution capacity of primary care.