Impact of CPAP Telemonitoring with Feedback on Adherence
HealthDay News — The use of continuous positive airway pressure therapy (CPAP) telemonitoring with automated feedback messaging improves 90-day adherence in patients with obstructive sleep apnea (OSA), according to a study published online August 31 in the American Journal of Respiratory and Critical Care Medicine.
Dennis Hwang, MD, from Southern California Permanente Medical Group in Fontana, and colleagues assessed 1,455 patients (51% women) referred for suspected OSA. Home sleep apnea testing was performed in 956 patients, and 556 were and prescribed CPAP. Patients were randomized to usual care, web-based OSA education (tel-ed added), CPAP telemonitoring with automated patient feedback (tel-TM added), or tel-ed and tel-TM added (tel-both).
The researchers found that CPAP average daily use at 90 days was 3.8, 4, 4.4, and 4.8 hours for the usual care, tel-ed, tel-TM, and tel-both groups, respectively. In the tel-TM and tel-both groups versus usual care, usage was significantly higher (P=0.0002 for both), but this was not the case for tel-ed (P=0.1). Adherence rates for Medicare patients were 53.5%, 61%, 65.6%, and 73.2% in the usual care, tel-ed, tel-TM, and tel-both groups, respectively (tel-both versus usual care, P=0.001; tel-TM versus usual care, P=0.003; tel-ed versus usual care, P=0.07). Telemedicine education did improve clinic attendance (show rate, 68.5 versus 62.7%; P=0.02).
"The use of CPAP telemonitoring with automated feedback messaging improved 90-day adherence in OSA patients," the authors write. "Telemedicine-based education did not significantly improve CPAP adherence but did increase clinic attendance for OSA evaluation."
Two authors are employed by ResMed, which partially funded the study.