Proven Methods To Keep Away From Afatinib Mishaps

Obstructive sleep apnoea syndrome (OSAS) affects 4% of middle-aged men and 2% of middle-aged women. It is characterized by the presence of repetitive upper airway obstruction during sleep. The main symptom is excessive daytime sleepiness. This disorder is known to be associated with high rates of morbidity and mortality, due mainly to cardiovascular diseases and traffic accidents (Giles et?al., 2006). The two mechanical treatment options for OSAS, continuous positive airway pressure (CPAP) and oral appliances (OAs), are constraining, lifelong treatments that do not meet with universal acceptance by users. Following recent recommendations (Kushida et?al., 2006), CPAP is indicated as a first-line treatment for patients suffering from severe OSAS (more than 30 apnoeas per hour of sleep), because it is always effective if used as instructed. However, the initial acceptance rate of CPAP is between 50 and 95% (McArdle et?al., 1999; Rauscher et?al., 1991) and the proportion of regular users (defined as using CPAP for more than 4?h per night at least 2 or 3 nights per week) varies from 46 to 80% (Kribbs et?al., 1993; P��pin et?al., 1999). For those patients who fail treatment attempts with CPAP, and also as a first-line treatment for patients with mild to moderate OSAS [apnoea�Chypopnoea index (AHI)? Although OAs have a generally lower effect on sleep apnoea and take longer to set up, due to their multidisciplinary approach (sleep medicine specialists, dentists) symptomatic improvement is often satisfactory, and these devices are usually well tolerated. In this latter situation in particular, patients and physicians are faced with important decisions regarding which treatment to choose. Physicians are not accustomed to sharing their decisions with patients. However, a growing number of patients would like to be involved in the decision-making process, and a growing number of physicians would like to involve the patient in the decision-making process. This requires, as a first step, a clear and unbiased explanation of the treatment options. A decision aid, called a decision board (DB), may be an effective way to address this issue. DBs are tools that provide standardized written and graphic evidence-based information about treatment options and their associated potential risks/benefits. This instrument has been developed in a number of clinical contexts, primarily regarding treatment options for cancer patients (De Abreu et?al., 2009; Elit et?al., 1996; Levine et?al., 1992; Milne et?al., 2009; Whelan et?al., 1999). As well as in randomized controlled trials, DBs have been shown to improve patient understanding and facilitate the decision-making process.