Digital Care Pathway for Patients With Sleep Apnea in Specialized Care: Mixed Methods Study.

Area of Science:

• Digital health interventions in respiratory medicine.
• Patient adherence and engagement in chronic disease management.

Background:

• Sleep apnea is a significant public health issue in Finland.
• Continuous positive airway pressure (CPAP) therapy is the primary treatment for moderate to severe sleep apnea.
• A sleep apnea digital care pathway (SA-DCP) was implemented at Oulu University Hospital for CPAP patients.

Purpose of the Study:

• To evaluate health care professionals' (HCPs') perspectives on the SA-DCP.
• To assess if SA-DCP meets its targets: shorter guiding sessions, reduced patient calls, and improved CPAP adherence.
• To understand patients' perspectives on the SA-DCP's usefulness.

Main Methods:

• Interviews with 6 HCPs.
• Surveys of 91 SA-DCP users and nonusers.
• Collection of CPAP device remote monitoring data from 170 patients.
• Analysis of registered phone call data from 2019-2021.
• Feedback from 446 patients on the SA-DCP.

Main Results:

• HCPs reported no significant workload improvement but noted communication flexibility.
• SA-DCP users showed higher engagement with pre-therapy information (74% vs 49%).
• CPAP adherence was high for both users and nonusers; patient calls did not decrease.
• SA-DCP users reported better digital literacy compared to nonusers (4.2 vs 3.2).

Conclusions:

• The SA-DCP did not achieve all its intended goals.
• Some patients preferred phone communication with HCPs despite SA-DCP use.
• Lower digital literacy and older age were significant factors for SA-DCP non-use.
• Future digital care pathways should consider user groups with lower digital literacy and older individuals.