Sleep Apnea: Assessment of Sleep Symptoms

ACP does not support QPP measure 276: "Sleep Apnea: Assessment of Sleep Symptoms." A performance gap is not documented and the measure addresses patients with a prior diagnosis of OSA, while current evidence does not support the benefit of symptom assessment beyond the initial diagnosis and in the absence of newly developed symptoms. In addition, there is no evidence describing an appropriate time interval for assessment of symptoms. We suggest the need to develop an overuse measure to ensure the assessment of symptoms is performed before the initiation of a sleep study. Furthermore, the measure is not feasible for use in the general population as it is currently written because it is administratively burdensome to collect data on every patient with OSA at every physician visit. For example, it is unclear how the measure would be applied to a primary care physician who is caring for patients with OSA, but often sees these patients for other health issues where it is not necessary to assess OSA symptoms. This measure appropriately assesses the performance of sleep medicine clinicians, but it is not appropriate to assess the performance of general internists.