The Effect of Telemonitoring (TM) on Improving Adherence with Continuous Positive Airway Pressure (CPAP) in Obstructive Sleep Apnoea (OSA): A Service Improvement Project (SIP)

Abstract

The benefits of CPAP demonstrated in clinical trials are difficult to deliver in real life due to the lack of adherence. We analysed the effect of a Telemonitoring (TM)-related intervention on adherence as part of a Service Improvement Project (SIP) analysed as a retrospective cohort study. The ‘historical control’ (HC) cohort (followed up in conventional clinics) included all patients who commenced on CPAP between 1 February and 30 April 2019 (n = 142). The ‘telemonitoring’ (TM) cohort included all patients who commenced on CPAP between 1 May and 31 July 2019 (n = 166). Adherence was checked at 30 days (baseline) and 73 days for both cohorts. Wilcoxon—Rank test was used for statistical analysis (results reported as mean ± SEM). Both cohorts had similar adherence at the 30-day baseline, compared to a significantly lower adherence in the HC-cohort at 73 days (55.7 ± 3.0 vs. 51.8 ± 3.2% of days ≥ 4 h: p = 0.0072, average usage 255 ± 12.8 vs. 236 ± 13.7 min: p = 0.0003). There was a significantly higher adherence in the TM-cohort at 73 days (50.8 ± 2.5 vs. 56.1 ± 2.9% of days ≥ 4 h: p = 0.0075; average usage 234 ± 10.4 vs. 252 ± 12.1 min: p = 0.0456). Telemonitoring-feedback is effective at improving adherence with CPAP, suggesting its potential beneficial role in the community setting, particularly in the post-COVID reality of increased remote consultations.

Quality of Life, Mental Health, and CPAP Compliance in Thai Patients with Obstructive Sleep Apnea during COVID-19 Pandemic

“…A study by Demirovic et al demonstrated that CPAP adherence improved during the COVID-19 lockdown in severe OSA patients [ 17 ]. Telemonitoring for CPAP use was effective at improving adherence to OSA treatment during the pandemic, as demonstrated in a study by Gassama et al [ 18 ]. Our results showed that the CPAP compliance rate was moderate, even without remote consultations and telemonitoring.…”

A Review of High-Flow Nasal Cannula Oxygen Therapy in the Management of Respiratory Failure and Chronic Obstructive Pulmonary Disease

“…Further studies are needed, particularly in post-acute hospital admission and stable hypercapnic COPD patients, to assess the effects on acute exacerbation rate, quality of life and admission-free survival. This may be enhanced with the utilisation of telemonitoring in improving compliance [59] .…”

High-Flow Nasal Cannula Oxygen Therapy in the Management of Respiratory Failure: A Review

“…Future work could include a comparison of outcomes between home HFNC versus home NIV. Furthermore, with the advancement of telemonitoring technology, there may be scope to enhance compliance with domiciliary respiratory support therapies [ 72 ].…”