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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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Peer-Driven Intervention for Care Coordination and Adherence Promotion for Obstructive Sleep Apnea: A Randomized,

Sairam Parthasarathy^1,2, Christopher Wendel^1,2, Michael A Grandner^1,3

¹University of Arizona Health Sciences Center for Sleep, Circadian, and Neuroscience Research.

American Journal of Respiratory and Critical Care Medicine

|October 23, 2024

Summary

Peer support via interactive voice response (IVR) systems significantly improved patient satisfaction and adherence to continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea. This approach enhances care coordination and patient outcomes.

Keywords:

adherence continuous positive airway pressure therapy patient satisfaction sleep apnea

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Area of Science:

Sleep Medicine
Health Services Research
Digital Health

Background:

Obstructive sleep apnea (OSA) is prevalent, with continuous positive airway pressure (CPAP) therapy being a common treatment.
Poor adherence to CPAP therapy is a significant challenge, negatively impacting patient outcomes and experiences.
Patient satisfaction is increasingly recognized as a crucial quality indicator in healthcare systems.

Purpose of the Study:

To evaluate if a peer-driven intervention delivered through an interactive voice response (IVR) system improves patient satisfaction.
To assess the impact of the IVR-based peer support on care coordination and CPAP adherence compared to an active control group.

Main Methods:

A 6-month randomized, parallel-group, controlled trial involving 263 patients across four centers.
Participants included both CPAP-naive patients and CPAP-adherent patients trained as mentors.
The intervention group received peer support via an IVR system; the control group received standard care.

Main Results:

Global patient satisfaction with sleep-specific services was significantly higher in the intervention group (4.57 ± 0.71) versus the control group (4.10 ± 1.13; P < 0.001).
CPAP adherence improved in the intervention group (4.5 h/night; 62.0% nights >4h use) compared to the control group (3.7 h/night; 51.4% nights >4h use; P=0.014 and P=0.023).
Improvements were noted in Patient Assessment of Chronic Illness Care (P=0.009) and Client Perception of Coordination Questionnaire (P=0.035) scores for the intervention group.

Conclusions:

Peer-driven intervention utilizing an IVR system effectively enhances patient satisfaction, CPAP adherence, and care coordination in OSA management.
The findings suggest that IVR-based peer support is a viable strategy for improving OSA treatment outcomes.
Reimbursement policies for peer support services could facilitate the widespread implementation of this intervention.