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Obstructive sleep apnoea (OSA) is an important public health problem with an estimated prevalence of 5–15% in the general population. This increases with age, peaking at 20–25% in individuals aged >65 years. This high prevalence of OSA in the elderly will presumably continue to grow as a consequence of the increasing longevity of the general population [1]. It is therefore not surprising that there is a steady increase in the percentage of patients >65 years of age referred to sleep units for suspicion of OSA and subsequently receiving continuous positive airway pressure (CPAP) therapy. One Spanish study that analysed 51 000 sleep studies from 16 sleep units revealed that one in four of these studies was performed in individuals aged ≥65 years, and that 69% of these were eventually treated with CPAP [2]. Despite this high prevalence, there is little information about long-term CPAP adherence in this population, especially in the very elderly (aged >80 years). We thus aimed to analyse the relationship between age at diagnosis and long-term CPAP adherence, in a large cohort of OSA patients aged ≥65 years who had been prescribed CPAP treatment.

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Introduction and aimsAlthough two thirds of smokers wish to quit, referral, uptake and engagement with smoking cessation (SC) services are frequently poor. In Leicester, uptake of smoking cessation referred from secondary care is approximately 20% with successful quit rate at four weeks of 10%. Provision of immediate support through smoking cessation specialist advice provided at the point of clinical assessment in outpatients might enhance referral uptake and quit rates. We assessed the value of this “in-clinic” approach in specialist respiratory outpatient clinics in two secondary care centres.MethodsProvision of immediate smoking cessation advice was implemented in two outpatient clinic services providing specialist care for patients with complex, chronic obstructive pulmonary disease (COPD); an Acute General Hospital (Peterborough City Hospital, PCH) and a Tertiary Care Hospital (Glenfield Hospital, GH). All current smokers were referred to an on-site smoking cessation specialist advisor by the physician, or clinic nurse, as part of their outpatient review on the same day of their clinic visit.In the Glenfield service SC was provided by a smoking cessation specialist, using a harm reduction approach with a guided patient-led tailored programme and the possibility of direct supply treatment at the initial assessment.In the PCH service, SC using psychosocial and/or pharmacological therapy was undertaken by a dedicated smoking cessation officerFollow-up visits and telephone calls were arranged separately by the smoking service and data including demographics, treatment uptake and quit rates after 4 weeks were analysed.ResultsA population of 122 smokers with a diagnosis of COPD were assessed for in-clinic SC over a period of twelve months in both centres.Demographic details of both cohorts, outcomes of both SC strategies including treatment uptake and quit rates are disclosed in Table 1.ConclusionsProviding “in-clinic”, expert smoking cessation advice results in favourable referral uptake and four week quit rates when compared with locally available data from paper based referral routes. Reinforcing physician delivered smoking cessation advice through immediate provision of proactive cessation support may be an effective means to enhance quit rates in secondary care.Abstract S124 Table 1Smoking cessation outcomesIn-Clinic SC Approach at Peterborough HospitalIn-Clinic SC Approach at Glenfield HospitalN patients referred6557Age (years) (mean, [SD])61.3 [9]61.1 [9]Gender53% Male53% MaleApproach to SCConventionalHarm ReductionTreatment Uptake (% of N)32 (49%)29 (50%)SC managed after 4 weeks (% of N)29 (44%)16 (28%)