Telemedicine Applications in Sleep Disordered Breathing

Verbraecken, Johan

doi:10.1016/j.jsmc.2016.08.007

Cited by 38 publications

(27 citation statements)

References 97 publications

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“…Telemonitoring of adherence, compliance, mask leaks, residual apnoeas and CPAP pressure Currently, the majority of CPAP devices on the market have wireless built-in connectivity, such that they have the ability to transfer technical data on a daily basis via a central secured data centre (a cloud) to sleep labs or home care providers [41,42]. It is also possible to remotely change the settings of the device [43]. The usefulness of telemonitoring for caregivers/patients has been reported in several randomised controlled trials (RCT), which are summarised in table 3.…”

Section: Managing Cpap Treated Patients With Tmmentioning

confidence: 99%

Telemedicine in the diagnosis and treatment of sleep apnoea

Bruyneel

2019

Eur Respir Rev

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@ERSpublicationsUsing telemedicine in obstructive sleep apnoea patients under continuous positive airway pressure therapy leads to reductions in nursing workload, early identification of problematic patients, and at least similar treatment adherence.ABSTRACT Telemedicine (TM) is a current tool in the landscape of medicine. It helps to address public health challenges such as increases in chronic disease in an ageing society and the associated burden in healthcare costs. Sleep TM refers to patient data exchange with the purpose of enhancing disease management. Obstructive sleep apnoea (OSA) syndrome is a chronic disorder associated with a significant morbidity, mainly cardiometabolic, and mortality. Obtaining adequate compliance to continuous positive airway pressure (CPAP) remains the greatest challenge related to OSA treatment, and the adoption of TM to support OSA management makes sense. In addition, the prevalence of OSA is growing and OSA is associated with increased healthcare costs that could be streamlined by the application of TM. In OSA, multiple modalities of TM are utilised, such as telediagnostics, teleconsultation, teletherapy and telemonitoring of patients being treated with CPAP. In the present article, I aim to provide an overview of current practice and the recent developments in TM for OSA management. Concerns related to TM use will also be addressed.

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Section: Managing Cpap Treated Patients With Tmmentioning

confidence: 99%

Telemedicine in the diagnosis and treatment of sleep apnoea

Bruyneel

2019

Eur Respir Rev

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“…Encore Anywhere (Philips) and AirView (ResMed)). Moreover, each company employs its own proprietary algorithm, complicating the interpretation of results by health professionals [30]. Despite this technological aspect, which is certainly useful, personal interactions between patients and healthcare professionals are also essential in telemedicine interventions, since patient customisation is required [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

“…As these new telemedicine strategies are explored, it is of paramount importance that physicians see them as a manageable, reliable and safe asset to their practice. Meanwhile, patients' technological barriers and quality concerns need to be openly faced and overcome to provide a simple and easy to use system [30].…”

Section: Discussionmentioning

confidence: 99%

Mobile health application to support CPAP therapy in obstructive sleep apnoea: design, feasibility and perspectives

et al. 2020

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BackgroundCurrent continuous positive airway pressure (CPAP) devices can be monitored remotely; however, in-person visits are kept for clinical follow-up in order to promote CPAP use and resolve potential side-effects. Mobile health is a promising way to provide remote and easy clinical control for CPAP follow-up and support. We aimed to evaluate the feasibility and acceptance by obstructive sleep apnoea (OSA) patients and healthcare professionals of a newly designed mobile app (Appnea-Q) to promote clinical control through a self-monitoring tool for patients with CPAP supervised by sleep professionals.MethodsAppnea-Q incorporates a simple follow-up questionnaire with automated responses, together with frequent problems and lifestyle recommendations sections. Feasibility, acceptance and usefulness were assessed. First, an internal validation was performed during outpatient CPAP follow-up visits with sleep professionals from various sleep units. Second, an external validation was performed in a subgroup of 15 patients at home.ResultsMost patients (n=75) considered the app useful and were willing to use it and recommend it (72–88%). Up to 64.87% agreed on its capacity to reduce hospital visits. Appnea-Q was rated as acceptable (79.37±19.29) by the system usability score. Sleep professionals (n=30) concurred on its usefulness for OSA patient follow-up, particularly during the first month of CPAP therapy. The external validation showed its feasibility among 11 out of 15 patients and their data were received accordingly on the professionals' web platform.ConclusionsAccording to our validation process, and the viewpoints of the patients and professionals, our new mobile app is a feasible and well-received tool for personal OSA management. Future clinical trials should substantiate its performance and cost-effectiveness in the clinical arena.

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“…Third, as a national system of government-funded health care, VA sleep medicine may differ from other health systems, especially those where PAP management is guided by health insurance directives. However, remote PAP monitoring has been increasing in non-VA settings [40,41]. Fourth, participants were not randomly allocated to the two groups.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the feasibility of implementing a Telesleep pilot program using two-tiered external facilitation

Rattray

Khaw

McGrath

et al. 2020

BMC Health Serv Res

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Background: Obstructive sleep apnea (OSA) can negatively impact patients' health status and outcomes. Positive airway pressure (PAP) reverses airway obstruction and may reduce the risk of adverse outcomes. Remote monitoring of PAP (as opposed to in-person visits) may improve access to sleep medicine services. This study aimed to evaluate the feasibility of implementing a clinical program that delivers treatment for OSA through PAP remote monitoring using external facilitation as an implementation strategy. Methods: Participants included patients with OSA at a Veteran Affairs Medical Center (VAMC). PAP adherence and clinical disease severity on treatment (measured by the apnea hypopnea index [AHI]) were the preliminary effectiveness outcomes across two delivery models: usual care (in-person) and Telehealth nurse-delivered remote monitoring. We also assessed visit duration and travel distance. A prospective, mixed-methods evaluation examined the two-tiered external facilitation implementation strategy. Results: The pilot project included N = 52 usual care patients and N = 38 Telehealth nurse-delivered remote monitoring patients. PAP adherence and disease severity were similar across the delivery modalities. However, remote monitoring visits were 50% shorter than in-person visits and saved a mean of 72 miles of travel (median = 45.6, SD = 59.0, mode = 17.8, range 5.4-220). A total of 62 interviews were conducted during implementation with a purposive sample of 12 clinical staff involved in program implementation. Weekly external facilitation delivered to both front-line staff and supervisory physicians was necessary to ensure patient enrollment and treatment. Synchronized, "two-tiered" facilitation at the executive and coordinator levels proved crucial to developing the clinical and administrative infrastructure to support a PAP remote monitoring program and to overcome implementation barriers.

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Telemedicine Applications in Sleep Disordered Breathing

Cited by 38 publications

References 97 publications

Telemedicine in the diagnosis and treatment of sleep apnoea

Telemedicine in the diagnosis and treatment of sleep apnoea

Mobile health application to support CPAP therapy in obstructive sleep apnoea: design, feasibility and perspectives

Evaluating the feasibility of implementing a Telesleep pilot program using two-tiered external facilitation

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