Accessibility and adherence to positive airway pressure treatment in patients with obstructive sleep apnea: a multicenter study in Latin America

Nogueira, Juan Facundo; Poyares, Dalva; Simonelli, Guido; Leiva, Sebastián; Carrillo-Alduenda, José Luis; Bazurto, María Angélica; Terán, Guadalupe; Valencia‐Flores, Matilde; Serra, Leonardo; Castro, Jorge Rey de; Santiago-Ayala, Victoria; Pérez-Chada, Daniel; Franchi, María Eugenia; Lucchesi, Lígia Mendonça; Tufik, Sérgio; Bittencourt, Lia Rita Azeredo

doi:10.1007/s11325-019-01881-9

Cited by 9 publications

(6 citation statements)

References 29 publications

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“…Cuando se compararon los dos centros participantes no hubo diferencias clínicamente relevantes. Las características de la población estudiada resultan similares a aquellas descriptas en estudios previos que incluían pacientes predominantemente de sexo masculino con sobrepeso y AOS de severidad moderado y severo (13,14) . Los resultados de la comparación del cumplimiento histórico con la pandemia fueron similares a los hallados por Attias (2020), comunicando un aumento del uso de la CPAP, a partir de un valor medio de 386 min por noche antes de la pandemia por COVID-19 a 401 minutos durante el aislamiento (15) .…”

Section: Discussionunclassified

Cumplimiento del tratamiento con CPAP en pacientes con apneas obstructivas del sueño durante la pandemia COVID-19 en dos hospitales de Capital Federal

Jaritos

Blanco

Nogueira

et al. 2023

Rev Fac Cien Med Univ Nac Cordoba

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Introducción: La terapia con CPAP es el tratamiento de primera línea para la apnea del sueño y su eficacia depende de la adherencia. El control y seguimiento de forma presencial fue limitado debido a que nuestro país se vio inmerso en aislamiento social debido a la pandemia por COVID-19 a partir de marzo del 2020. Con el objeto de evaluar si se mantuvo la adherencia de la CPAP en pacientes con apnea obstructiva del sueño (AOS), en dos hospitales durante la pandemia COVID-19 y compararlo con la situación prepandemia sobre una base de control histórico de la ciudad de Buenos Aires. Métodos: Estudio observacional y retrospectivo basado en datos de recolección sistemática de adherencia a la CPAP e índice de apnea-hipopnea (IAH) residual. Para la comparación, se utilizó como referencia un control histórico correspondiente al periodo especular (mayo a diciembre de cada año entre el 2016 y 2019). Se incluyeron pacientes de más de 18 años de edad, con AOS con terapia con CPAP de más de 30 días de tratamiento. Se excluyeron pacientes con otras patologías respiratorias crónicas que requerían de terapias de ventilación (Bi-level, servo ventilación, ventilación con volumen asegurado). Resultados: Fueron evaluados 151 pacientes prepandemia y 127 del periodo pandemia respectivamente. Hombres 98 (65%) vs. 50 (60.3%) p: 0.9, edad de 65.4± 11.9 vs 63.6 ± 12.6 p: 0.22, índice de masa corporal 31.5 ± 5.0 vs. 31.2 ± 5.3 kg/m2 p: 0.6, respectivamente En ambos centros, el tratamiento más utilizado fue CPAP fijo; 90 (59.6%) vs. 96 (75.6%) p: 0.005. Existió un aumento en el cumplimiento del mismo en comparación al periodo prepandémico en minutos/noche [341.4 IC 95% 292.4 - 340.6 vs. 274.3 IC 95% 208.5 - 267.4, p: 0.001] y reducción del IAH residual [3.3 IC 95% 2.0 - 3.05 vs. 6.3 IC 95% 2.6 - 4.3 p: 0.006]. Conclusiones: En el periodo de pandemia COVID-19 se observó mayor adherencia al tratamiento con CPAP en pacientes con apneas del sueño.

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Section: Discussionunclassified

Cumplimiento del tratamiento con CPAP en pacientes con apneas obstructivas del sueño durante la pandemia COVID-19 en dos hospitales de Capital Federal

Jaritos

Blanco

Nogueira

et al. 2023

Rev Fac Cien Med Univ Nac Cordoba

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“…В свою очередь, коморбидность, как правило, нарастает с возрастом. В нашем исследовании, так же как и в ряде других [40][41][42][43][44][45][46][47][48][49][50], приверженные ПАП-терапии больные оказались старше по возрасту и имели более высокий ИАГ в сравнении с неприверженными. В многоцентровом исследовании J. Nogueira и соавт.…”

Section: Discussionunclassified

“…В многоцентровом исследовании J. Nogueira и соавт. аналогично результатам нашей работы выявлено, что пациенты (n=880) с лучшей приверженностью старше (55,3±13,0 года против 52,0±13,0 года; p=0,002) и имели более тяжелый СОАС (ИАГ 51,8±27,0 против 45,6±27,0; p=0,001) [40].…”

Section: Discussionunclassified

PAP-therapy adherence in patients with obstructive sleep apnea and cardiovascular diseases

et al. 2021

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Materials and methods. The study included 119 patients with obstructive sleep apnea (OSA) and cardiovascular diseases (CVD) who were followed up at the National Medical Research Center of Cardiology of the Ministry of Health of the Russian Federation in the period from 2012 to 2020, and have been receiving positive airway pressure (PAP) therapy (93 men, 78.2%). The median follow-up was 3.0 years [1.5; 5.0]. The adherence criteria were the following: the usage of the PAP device for at least 71% of nights a year, and at least 4 hours per night. Results. 64.3% of patients met the criteria for adherence to PAP therapy (use more than 4 hours/night, more than 71% of nights). The adherent patients were older (64.0 years [58.5; 68.0] versus 59.0 years [53.0; 65.0] resp., p=0.03) and had a higher apnea-hypopnea index AHI (47.7 events/h [37.5; 64.4] versus 38.2 events/h [30.4; 52.7] resp., p=0.04). Patients with stage III of hypertension were using a PAP device every night significantly less (3.4 h/night [1.1; 3.6] versus 6.3 h/night [5.3; 7.4] respectively, p=0.00) in comparison with patients with hypertension stages III. The adherence of patients with or without coronary artery disease (CAD) and paroxysmal atrial fibrillation (AF) did not differ. There was no significant difference in the incidence of stage III hypertension, CAD, and permanent AF between the groups of adherent and non-adherent to PAP therapy patients. Conclusion. 63.4% of patients with CVD were adherent to PAP therapy. Adherent patients were older and had a higher AHI. Patients with stage III hypertension were worse adherent to PAP therapy in comparison with patients with hypertension of lesser stages. The CVDs course in adherent and non-adherent patients did not differ.

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“…Patients' adherence to CPAP is poor and despite multiple interventions, it has not improved in recent years (13), being a limiting factor of this treatment. A study in five countries in Latin America showed that only 55.7% of patients diagnosed with OSA started CPAP and of these, only 47% used CPAP after one year (14) The reasons for poor adherence are multiple and related to motivational and psychological factors, perceived efficacy (15) and side effects caused by the mask or the pressure, which sometimes result in discontinuation of treatment (16). The influence of gender on adherence is unclear.…”

Section: Materiales Y Métodos Estudio De Cohorte úNica De Antes Y Despuésmentioning

confidence: 99%

Sex differences regarding the impact of a standardized adaptation session in Colombian patients with obstructive sleep apnea and poor adherence to positive airway pressure devices

et al. 2021

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Introduction: Positive airway pressure (PAP) is the most effective treatment for obstructive sleep apnea (OSA) but adherence is poor. The Sleep-disordered breathing clinic of Fundación Neumológica Colombiana (FNC) has a standardized adaptation session (SAS) aimed at patients with difficulties in using PAP devices. Objective: To evaluate the impact of a SAS in short-term adherence to PAP therapy in patients with OSA and to determine sex differences. Materials and methods: Before-after single cohort study conducted in 40 people aged ≥ 18 years with an AHI ≥ 15/hour and treated at the FNC, Bogotá D.C. (Colombia) between 2015 and 2017, and who attended a SAS due to poor adherence to PAP therapy (defined as <4 hours use in 70% of nights). Data on the hours of use of the PAP device and the % of days in which it was used >4 hours were recorded before and after the intervention to evaluate changes in patients’ adherence. Descriptive statistics were used for data analysis. The paired samples t-test was used for the comparison of variables before and after the intervention. Results: A significant increase was observed in the PAP device use (1.8 hours, 95%CI: 1.3-2.3; p<0.001) and in the % of days its use was >4 hours (35.6%, 95%CI: 26.0-45.3; p<0.001); in men the increase was greater in both cases (2.3 hours, 95%CI: 1.7-2.9; p=0.029 and 47.8%, 95%CI: 32.9-62.8; p=0.029). Conclusion: The SAS offered by the FNC, which includes education strategies and the identification and solving of barriers hindering the use of PAP devices, significantly increased the hours of use of the device and the % of days in which it was used more than 4 hours in the study population, in particular in men.

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Accessibility and adherence to positive airway pressure treatment in patients with obstructive sleep apnea: a multicenter study in Latin America

Cited by 9 publications

References 29 publications

Cumplimiento del tratamiento con CPAP en pacientes con apneas obstructivas del sueño durante la pandemia COVID-19 en dos hospitales de Capital Federal

Cumplimiento del tratamiento con CPAP en pacientes con apneas obstructivas del sueño durante la pandemia COVID-19 en dos hospitales de Capital Federal

PAP-therapy adherence in patients with obstructive sleep apnea and cardiovascular diseases

Sex differences regarding the impact of a standardized adaptation session in Colombian patients with obstructive sleep apnea and poor adherence to positive airway pressure devices

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