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Adherence in children using positive airway pressure therapy: a big-data analysis
Rakesh Bhattacharjee1, Adam V Benjafield2, Jeff Armitstead2
1Rady Children's Hospital and Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.
The Lancet. Digital Health
|December 18, 2020
Summary
Positive airway pressure (PAP) therapy adherence in children is lower than in adults, with over 60% using it continuously for 90 days. Factors like age and engagement programs impact adherence.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Biomedical Data Science
Background:
- Positive airway pressure (PAP) is a key treatment for pediatric sleep-disordered breathing.
- Large-scale data on pediatric PAP adherence and influencing factors are limited.
- This study addresses the need for clarity on PAP therapy tolerance and adherence in children.
Purpose of the Study:
- To investigate adherence patterns in a large pediatric population undergoing PAP therapy.
- To identify factors associated with better adherence to PAP treatment in children.
- To provide insights for improving PAP therapy management in pediatric patients.
Main Methods:
- Cross-sectional big-data analysis of PAP device usage from the AirView cloud database (Oct 2014 - Aug 2018).
- Inclusion criteria: US-based patients aged 4-17 years using continuous or automated PAP devices.
- Primary outcome: Proportion of patients using PAP continuously for 90 days; analysis of associated factors.
Main Results:
- Data from 20,553 eligible children (mean age 13.0 years) were analyzed.
- 61.8% of pediatric patients demonstrated continuous PAP use over 90 days.
- Adherence was associated with age, residual apnea-hypopnea index, engagement programs, PAP pressure, and mask leak.
Conclusions:
- This study is the largest analysis of pediatric PAP therapy adherence to date.
- Pediatric PAP adherence appears lower compared to adult populations.
- Actionable factors identified can guide clinical strategies to enhance PAP adherence in children.
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