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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

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Medication adherence and persistence in severe obstructive sleep apnea.

Isabel Villar¹, Monica Izuel, Santiago Carrizo

¹Pharmacy Services, Hospital Universitario Miguel Servet, Zaragoza, Spain.

|June 2, 2009

Summary

Patients with severe obstructive sleep apnea (OSA) taking cardiovascular medications showed similar adherence and persistence regardless of continuous positive airway pressure (CPAP) treatment compliance. This suggests CPAP use does not significantly impact medication adherence in this population.

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Published on: October 18, 2024

Area of Science:

Cardiology
Pulmonology
Pharmacology

Background:

Severe obstructive sleep apnea (OSA) is associated with increased cardiovascular risk.
Patients with OSA often require multiple medications for cardiovascular disease management.
Continuous positive airway pressure (CPAP) is a primary treatment for OSA, but adherence varies.

Purpose of the Study:

To compare medication adherence and persistence in patients with severe OSA based on their compliance with CPAP therapy.
To evaluate the 2-year adherence and persistence rates of antihypertensives, statins, and antiplatelets in OSA patients with and without CPAP use.

Main Methods:

A 2-year prospective longitudinal study of 2158 patients with severe OSA (apnea-hypopnea index >30).
Medication adherence assessed via Medication Possession Ratio (MPR); persistence defined as prescription refills within the last 30 days.
CPAP use categorized as adequate (>4 h/day) versus non-use/discontinuation (<4 h/day).

Main Results:

No significant difference in 2-year MPR for antihypertensives, statins, or antiplatelets between CPAP users and non-users.
Female sex and higher comorbidity count predicted good medication adherence (MPR > 80%).
2-year medication persistence rates were comparable between the CPAP and non-CPAP groups.

Conclusions:

CPAP treatment compliance does not appear to influence medication adherence or persistence for cardiovascular drugs in patients with severe OSA.
Adherence to protective cardiovascular medications remains consistent irrespective of CPAP use in this patient cohort.