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Impact of an Extended Telemonitoring and Coaching Program on Continuous Positive Airway Pressure Adherence
Sanjay R Patel1,2, Jessie P Bakker3, Christy J Stitt3
1Center for Sleep and Cardiovascular Outcomes Research and.
Annals of the American Thoracic Society
|July 20, 2022
Summary
A 12-month telemonitoring and coaching program significantly improves continuous positive airway pressure (CPAP) adherence in obstructive sleep apnea patients long-term. Short-term support (3 months) shows initial gains but lacks lasting impact.
Area of Science:
- Sleep Medicine
- Respiratory Therapy
- Digital Health
Background:
- Continuous positive airway pressure (CPAP) therapy is crucial for obstructive sleep apnea (OSA).
- Patient adherence to CPAP therapy is a significant challenge impacting treatment efficacy.
- Telemonitoring and coaching interventions show promise for improving CPAP adherence but optimal duration is unknown.
Purpose of the Study:
- To compare the effectiveness of 12-month versus 3-month telemonitoring and coaching programs on CPAP adherence.
- To evaluate the long-term impact of behavioral support duration on CPAP usage.
- To identify optimal support durations for sustained CPAP adherence.
Main Methods:
- Real-world CPAP adherence data from patients initiated between July 2018 and April 2020 were analyzed.
- Patients were categorized into three groups: 12-month support, 3-month support, and no support.
- Mean monthly CPAP adherence was calculated over 18 months, with missing data imputed as zero use. Analyses were adjusted for age, sex, and provider.
Main Results:
- The 3-month support group showed short-term adherence improvement at Month 3 but declined to baseline levels by Months 12 and 18.
- The 12-month support group demonstrated significantly greater CPAP use at Months 3, 12, and 18 compared to the no-support group.
- Sustained improvements in CPAP adherence were observed with the 12-month program, although benefits decreased after support cessation.
Conclusions:
- A 3-month telemonitoring/coaching program offers short-term benefits for CPAP adherence but does not yield sustained improvements.
- A 12-month program leads to sustained improvements in CPAP adherence, highlighting the importance of longer support durations.
- Implementing extended telemonitoring and coaching programs is vital for maximizing long-term benefits of CPAP therapy in OSA patients.
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