Added value of technician intervention to improve mask management for apneic patients treated with long-term CPAP

Long-term management of sleep apnea patients treated with CPAP raises questions about the cost-effectiveness of certain resources. With the growing use of remote CPAP monitoring and patient questionnaires, the importance of direct patient supervision by technicians is being challenged. To date, no real-life study has investigated the long-term additional value of a technician in evaluating common CPAP side effects compared to patient-reported side effects.

InterfaceVent-CPAP is a prospective real-life cross-sectional study conducted in a cohort of apneic adults treated with CPAP for at least 3 months. Three common CPAP side effects (pain, erythema, and leaks) were independently assessed by the patient and the technician on visual analogue scales and diagrams, respectively. CPAP-reported leaks were also collected. Gwet's concordance coefficient was used to analyze concordance between patient and technician assessments of CPAP side effects.

1484 patients (median age 67 years (IQ_25-75: 60-74)) were evaluated by 32 technicians. Correlation between CPAP-reported leaks and technician-reported leaks was weak. For pain and erythema, moderate to high concordance was observed between technician and patient responses, while no concordance was found for leaks. Univariate linear regression analyses examining the effect of technician-reported areas of pain, erythema and leaks on the Epworth-Sleepiness-Scale revealed statistically significant associations between sleepiness in women and certain technician-reported areas of mask leaks and mask pain.

Direct supervision of chronic apneic patients by technicians adds value in managing mask-related issues. Long-term care should include a combination of remote CPAP monitoring, patient-reported outcomes, and technician direct supervision.

InterfaceVent is registered with ClinicalTrials.gov (NCT03013283). First registration date is 2016-12-23.