Telemonitoring, Telemedicine Education Improves 90-Day CPAP 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 in the American Journal of Respiratory and Critical Care Medicine.

Dennis Hwang, MD, from Southern California Permanente Medical Group in Fontana, and colleagues assessed 1455 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 =.0002 for both), but this was not the case for tel-ed (P =.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 =.001; tel-TM versus usual care, P =.003; tel-ed versus usual care, P =.07). Telemedicine education did improve clinic attendance (show rate, 68.5% vs 62.7%; P =.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.”

Disclosures: Two authors are employed by ResMed, which partially funded the study.

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Hwang D, Chang JW, Benjafield AV, et al. Effect of telemedicine education and telemonitoring on CPAP adherence: the tele-OSA randomized trial [published August 31, 2017]. Am J Resp Crit Care Med. doi:10.1164/rccm.201703-0582OC