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

Natalie Gentin; Timothy P Howarth; Graeme Crossland; Hemi Patel; Catherine Jonas; Gregory Blecher; John Widger; Annie Whybourne; Subash S Heraganahally

doi:10.1111/jpc.16549

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

J Paediatr Child Health. 2024 May 10. doi: 10.1111/jpc.16549. Online ahead of print.

Authors

Natalie Gentin^{1

2

3}, Timothy P Howarth^{1

4

5}, Graeme Crossland⁶, Hemi Patel⁶, Catherine Jonas^{1

7}, Gregory Blecher^{1

2

8}, John Widger⁹, Annie Whybourne¹⁰, Subash S Heraganahally^{1

11

12}

Affiliations

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.

PMID: 38726707
DOI: 10.1111/jpc.16549

Abstract

Aim: This 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.

Methods: Video 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.

Results: Of 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.

Conclusions: This 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.

Keywords: aboriginal; adeno‐tonsillectomy; children; first nations; polysomnography; sleep apnoea.

© 2024 The Authors. Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).