Multidimensional Evaluation of Continuous Positive Airway Pressure (CPAP) Treatment for Sleep Apnea in Different Clusters of Couples

Mendelson, Monique; Gentina, Thibaut; Gentina, Élodie; Tamisier, Renaud; Pépin, Jean-Louis; Bailly, Sébastien

doi:10.3390/jcm9061658

Cited by 14 publications

(9 citation statements)

References 34 publications

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“…Disease severity, psychological factors and management of side effects related to CPAP have been associated with treatment adherence [ 12 ]. Moreover, it has recently been reported that physical and social characteristics of the patient–spouse couple also impact on adherence [ 13 ]. This finding highlights the possibility that other patient characteristics could contribute to long-term adherence to CPAP therapy.…”

Section: Introductionmentioning

confidence: 99%

CPAP Therapy Termination Rates by OSA Phenotype: A French Nationwide Database Analysis

Pépin¹,

Bailly²,

Rinder³

et al. 2021

JCM

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The nationwide claims data lake for sleep apnoea (ALASKA)—real-life data for understanding and increasing obstructive sleep apnea (OSA) quality of care study—investigated long-term continuous positive airway pressure (CPAP) termination rates, focusing on the contribution of comorbidities. The French national health insurance reimbursement system data for new CPAP users aged ≥18 years were analyzed. Innovative algorithms were used to determine the presence of specific comorbidities (hypertension, diabetes and chronic obstructive pulmonary disease (COPD)). Therapy termination was defined as cessation of CPAP reimbursements. A total of 480,000 patients were included (mean age 59.3 ± 13.6 years, 65.4% male). An amount of 50.7, 24.4 and 4.3% of patients, respectively, had hypertension, diabetes and COPD. Overall CPAP termination rates after 1, 2 and 3 years were 23.1, 37.1 and 47.7%, respectively. On multivariable analysis, age categories, female sex (1.09 (1.08–1.10) and COPD (1.12 (1.10–1.13)) and diabetes (1.18 (1.16–1.19)) were significantly associated with higher CPAP termination risk; patients with hypertension were more likely to continue using CPAP (hazard ratio 0.96 (95% confidence interval 0.95–0.97)). Therapy termination rates were highest in younger or older patients with ≥1 comorbidity. Comorbidities have an important influence on long-term CPAP continuation in patients with OSA.

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Section: Introductionmentioning

confidence: 99%

CPAP Therapy Termination Rates by OSA Phenotype: A French Nationwide Database Analysis

Pépin¹,

Bailly²,

Rinder³

et al. 2021

JCM

Self Cite

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“…This is in line with several other studies. Most European studies carried out in the last 10 years show that adherence to CPAP can vary from 50 to 90% [18][19][20][21]. A review of 82 studies showed that about a third of treated patients had poor adherence [22].…”

Section: Discussionmentioning

confidence: 99%

Adherence to home ventilation therapy in patients with Obstructive Sleep Apnea Syndrome: prevalence, determinants and costs of non-compliance. A cross-sectional study

Martins¹,

Passos²,

Peixoto³

et al. 2021

fmpcr

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Background. Obstructive sleep apnea (OSA) is a common chronic disease with high impact both as an independent cardiovascular risk factor and in quality of life. Home positive pressure ventilation is the main available therapeutic intervention, depending on its utilization by patients. Objectives. Our aim was to determine the adherence to home ventilation therapy, prospecting for the determinants of compliance. Secondarily, we evaluated the direct costs of non-adherence. Material and methods. We conducted a cross-sectional study based on retrospective analysis of a sample of 1,183 OSA patients followed in a pulmonology department during 2018. Patients with less than 180 days of utilization were excluded. The adherence to ventilation therapy was defined by utilization of more than 4 hours a day, at least 70% of the days. Costs were calculated using Portuguese official prices for reimbursement. Results. A total of 744 patients were included for analysis. The adherents were 63.4% (95% CI: 60.5-67.4%). Ageing (p = 0.014), severity of disease at diagnosis (p = 0.044), room sharing (p = 0.002), working in the primary economic sector (p = 0.014) and using BiPAP (p = 0.046) were associated with higher adherence. The total costs of non-adherence were estimated at 112,373.68 €. Conclusions. The adherence of patients to treatments is a relevant topic of discussion. Our results are concordant with literature, reinforcing the importance of holding the patient accountable to improve compliance with treatment. Adherence is lower than necessary to achieve the maximization of the therapeutic benefits, leading to a higher burden of disease, higher costs and significant waste.

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“…Prior to the delivery of the interventions, the authors built multiple clusters to give personalized interventions to the couples and patients. Mendelson et al explores deeper this clustering for the patients and their partners with advanced and automatic clustering methods [22]. Another study carried out by Ye et al also involved the partners [23].…”

Section: Pap Interventionsmentioning

confidence: 99%

A comprehensive mHealth solution for OSA patient management

Joymangul

Sekhari

Grasset³

et al. 2022

Preprint

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Obstructive Sleep Apnea (OSA) is a potentially fatal sleep disease that causes a variety of pathologies. Positive Airway Pressure (PAP) therapy is the preferred treatment for OSA. Nonetheless, when compared to the other 17 therapies, the PAP therapy has one of the lowest levels of compliance. We present 2 novel mHealth solutions for improving this adherence level in CPAP therapy. The first application, Sleep.py Experts, provides a variety of decision support tools to enable tailored patient management for PAP treatment. The end-users for Sleep.py Experts are the multiple stakeholders that are involved in the PAP therapy like the pulmonologist, The second application, Sleep.py, delivers motivational, educational, diet, physical activity and stress management interventions directly to the patient suffering from OSA. We include an innovative serious game to increase the patient’s compliance with the application. Sleep.py provides the most comprehensive collection of personalized interventions for PAP therapy. Another core feature of these applications is to collect feedback from either the experts or the patients, In this research, we also present a framework for creating this feedback and propagating them across various machine learning models in a continuous learning process. This paradigm is adaptable enough to be used in different therapies or fields. To summarise, we offer a clear roadmap for implementing a continuous learning method based on expert-validated outcomes.

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Multidimensional Evaluation of Continuous Positive Airway Pressure (CPAP) Treatment for Sleep Apnea in Different Clusters of Couples

Cited by 14 publications

References 34 publications

CPAP Therapy Termination Rates by OSA Phenotype: A French Nationwide Database Analysis

CPAP Therapy Termination Rates by OSA Phenotype: A French Nationwide Database Analysis

Adherence to home ventilation therapy in patients with Obstructive Sleep Apnea Syndrome: prevalence, determinants and costs of non-compliance. A cross-sectional study

A comprehensive mHealth solution for OSA patient management

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