Effects of telemedicine interventions in improving continuous positive airway pressure adherence in patients with obstructive sleep apnoea: a meta-analysis of randomised controlled trials

Hu, Yuli; Su, Yijia; Hu, Sanlian; Ma, Jun; Zhang, Zuo-yan; Fang, Fang; Guan, Jian

doi:10.1007/s11325-021-02292-5

Cited by 24 publications

(17 citation statements)

References 47 publications

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“…Research also shows that motivational interventions can effectively be provided digitally to patients with OSAS using CPAP (Hu et al, 2021 ), with proven advantages and reduced costs (Appel et al, 2011 ; Bus et al, 2018 ). Further investigations should focus on the use of the different format of delivering motivational interventions including the use of new technologies, or the provision of motivational interventions in group settings (Velasquez et al, 2006 ; Channon et al, 2007 ; Tucker et al, 2017 )—as the group format requires specific competence and additional tasks, and the motivational strategies are far more complex to operate than in individual sessions (Major and Palmer, 2001 ; Britt et al, 2004 ; Pietrabissa, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Improving CPAP Adherence in Adults With Obstructive Sleep Apnea Syndrome: A Scoping Review of Motivational Interventions

et al. 2021

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Objective: This scoping review aims to provide an accessible summary of available evidence on the efficacy of motivational interventions to increase adherence to Continuous Positive Airway Pressure (CPAP) among patients with Obstructive Sleep Apnea Syndrome (OSAS) and of their specific aspects and strategies by assessing adherence measures.Methods: A literature search was performed in PubMed, Scopus, Medline, PsycINFO, and Web of Science databases using the concepts of “obstructive sleep apnea syndrome,” “continuous positive airway pressure,” “motivational intervention,” and “adherence.” Rigorous inclusion criteria and screening by at least two reviewers were applied. Data were extracted to address the review aims and were presented as a narrative synthesis.Results: Search for databases produced 11 randomized controlled trials, all including naïve CPAP users. Findings showed that motivational interventions were more effective than usual care and educational programs in increasing adherence to CPAP, despite results were not always maintained over time across studies.Discussion: To our knowledge, this is the first scoping review of the literature aimed to explore the characteristics and impact of motivational interventions to promote adherence to CPAP in patients with OSAS. More research providing a detailed description of motivational strategies, and testing of their association with positive treatment outcomes via both direct and indirect measures are needed to increase awareness on active mechanisms of change.

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Section: Discussionmentioning

confidence: 99%

Improving CPAP Adherence in Adults With Obstructive Sleep Apnea Syndrome: A Scoping Review of Motivational Interventions

et al. 2021

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“…The new strategies developed to maintain activity in the sleep units have been achievable as a result of previous experience in telemedicine (21)(22)(23), and, more than a temporary solution, they could represent an option to be considered in regular activity.…”

Section: Discussionmentioning

confidence: 99%

“…Patients in both telemedicine strategies reported easy access to healthcare professionals, felt confident about the security of their confidential data and would recommend the telemedicine strategy used to others. The loss of the human patient-doctor relationship is the greatest risk of telemedicine use (21,23); however, these studies show the potential of bringing the patient closer to the doctor when the technology is used appropriately.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine home CPAP titration and follow-up in the COVID-19 scenario

et al. 2022

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Obstructive sleep apnea (OSA) is a highly prevalent chronic disease associated with important comorbidities such as traffic accidents, cardiovascular and metabolic diseases and mortality, among others [1]. Continuous positive airway pressure (CPAP), a first-line therapy in moderate-severe OSA [2], has been proven successful in improving daytime sleepiness, quality of life, reducing traffic accidents [3], improving hypertension and paroxistical atrial fibrillation [4, 5]. However, 47% of successfully titrated patients abandon treatment within three years [5, 6]. Thus, early OSA and CPAP education with close follow-up is mandatory to achieve satisfactory CPAP compliance [6, 7]. In that context, telemedicine and telemonitoring through remote monitoring CPAP have become promising strategies [8, 9]. Recently, smartphone applications [10] and wearables [11] have been added as new suggested tools for improving CPAP compliance.

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“…[106,111] A meta-analysis (n=11 RCTs; 1440 patients) concluded that overall telemedicine improved adherence compared to centre-based care. [112] Clinical outcomes (for example Epworth Sleepiness Score) were generally reported as similar between groups, [59,105,109,113] and there is evidence that telehealth is more cost-effective than traditional in-person follow-up. [108,110,113,114] Telemonitoring and video consultations (see Figure 4) are generally well accepted by patients using CPAP therapy.…”

Section: Monitoring To Support Remote Consulting In Obstructive Sleep...mentioning

confidence: 94%

Telemedicine and virtual respiratory care in the era of COVID-19

Pinnock

Murphie²,

Vogiatzis

et al. 2022

ERJ Open Res

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The World Health Organization defines telemedicine as “an interaction between a health care provider and a patient when the two are separated by distance”. The COVID-19 pandemic has forced a dramatic shift to telephone and video consulting for follow up and routine ambulatory care for reasons of infection control. Short Message Service (“text”) messaging has proved a useful adjunct to remote consulting allowing transfer of photographs and documents. Maintaining non-communicable diseases care is a core component of pandemic preparedness and telemedicine has developed to enable (for example) remote monitoring of sleep apnoea, telemonitoring of chronic obstructive pulmonary disease, digital support for asthma self-management, remote delivery of pulmonary rehabilitation. There are multiple exemplars of telehealth instigated rapidly to provide care for people with COVID-19, to manage the spread of the pandemic, or to maintain safe routine diagnostic or treatment services.Despite many positive examples of equivalent functionality and safety, there remain questions about the impact of remote delivery of care on rapport and the longer-term impact on patient/professional relationships. Although telehealth has the potential to contribute to universal health coverage by providing cost-effective accessible care, there is a risk of increasing social health inequalities if the “digital divide” excludes those most in need of care. As we emerge from the pandemic, the balance of remote versus face-to-face consulting, and the specific role of digital health in different clinical and healthcare contexts will evolve. What is clear is that telemedicine in one form or another will be part of the “new norm”.

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Effects of telemedicine interventions in improving continuous positive airway pressure adherence in patients with obstructive sleep apnoea: a meta-analysis of randomised controlled trials

Cited by 24 publications

References 47 publications

Improving CPAP Adherence in Adults With Obstructive Sleep Apnea Syndrome: A Scoping Review of Motivational Interventions

Improving CPAP Adherence in Adults With Obstructive Sleep Apnea Syndrome: A Scoping Review of Motivational Interventions

Telemedicine home CPAP titration and follow-up in the COVID-19 scenario

Telemedicine and virtual respiratory care in the era of COVID-19

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