Establishing a telehealth model addressing paediatric sleep health in remote and rural Northern Territory Australia: Overcoming the distance barrier

Author:

Gentin Natalie123ORCID,Howarth Timothy P145ORCID,Crossland Graeme6,Patel Hemi6,Jonas Catherine17,Blecher Gregory128,Widger John9,Whybourne Annie10,Heraganahally Subash S11112ORCID

Affiliation:

1. Darwin Respiratory and Sleep Health Darwin Private Hospital Darwin Northern Territory Australia

2. Sydney Children's Hospital Sydney New South Wales Australia

3. University of New South Wales Sydney New South Wales Australia

4. Department of Applied Physics University of Eastern Finland Kuopio Northern Savonia Finland

5. Diagnostic Imaging Center Kuopio University Hospital Kuopio Northern Savonia Finland

6. Department of ENT Royal Darwin Hospital Darwin Northern Territory Australia

7. Paediatric Sleep Service Northern Beaches Hospital Frenchs Forest New South Wales Australia

8. Liverpool Paediatric Care Liverpool New South Wales Australia

9. Division of Paediatric Medicine Women's and Children's Hospital Adelaide South Australia Australia

10. Women Children and Youth Division NT Health Darwin Northern Territory Australia

11. Department of Respiratory and Sleep Medicine Royal Darwin Hospital Darwin Northern Territory Australia

12. College of Medicine and Public Health Flinders University Darwin Northern Territory Australia

Abstract

AimThis study examined the outcomes of a telehealth model for sleep health assessment among Indigenous and non‐Indigenous children residing in remote and regional communities at the Top End Northern Territory (NT) of Australia.MethodsVideo telehealth consultation, that included clinical history and relevant physical findings assessed virtually with an interstate paediatric sleep physician was conducted remotely. Polysomnography (PSG) and therapeutic interventions were carried out locally at Darwin, NT. The study participants were children referred between 2015 and 2020.ResultsOf the total 812 children referred for sleep assessment, 699 underwent a diagnostic PSG. The majority of patients were female (63%), non‐Indigenous (81%) and resided in outer regional areas (88%). Indigenous children were significantly older and resided in remote or very remote locations (22% vs. 10%). Referral patterns differed according to locality and Indigenous status – (non‐Indigenous via private (53%), Indigenous via public system (35%)). Receipt of referrals to initial consultation was a median of 16 days and 4 weeks from consult to PSG. Remote children had slightly longer time delay between the referral and initial consult (32 vs. 15 days). Fifty one percent were diagnosed to have OSA, 27% underwent adenotonsillectomy and 2% were prescribed with CPAP therapy.ConclusionsThis study has demonstrated that a telehealth model can be an effective way in overcoming logistical barriers and in providing sleep health services to children in remote and regional Australia. Further innovative efforts are needed to improve the service model and expand the reach for vulnerable children in very remote communities.

Publisher

Wiley

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