Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients

Park, Ji-Hwan; Kang, Ji-Hun; Seo, Myeonggu; Kwon, Ha-Nee; Kim, Sung‐Dong; Cho, Kyu‐Sup

doi:10.17241/smr.2020.00766

Cited by 3 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While using PAP, patients must wear face masks such as full-face masks, nasal masks and nasal pillows, and the masks are connected to the PAP machine with a hose. Previous study showed that during the adaptation period, discomfort from mask was the predominant reason for quitting PAP therapy 9 . To prevent the air leaks, the PAP mask should fit snugly to the face while not being too tight to cause any pain or irritation.…”

Section: Discussionmentioning

confidence: 98%

“…According to a report which investigated the patterns of CPAP use of OSA patients, only 46% of patients met the criteria of regular users which was defined by administration of PAP device for at least 4 h in at least 70% of all nights 17 . Although adherence rate was increased after NHI coverage because the cost of PAP therapy is also one of the important factors for improving PAP adherence 9 , 18 , identifying the predictors of PAP adherence is important in managing OSA and lowering the risk of comorbidity. Furthermore, there are few identified PSG variables which can be used to reliably predict the PAP adherence.…”

Section: Discussionmentioning

confidence: 99%

“…These factors are known to be associated with poor adherence. In contrast, adherence can be significantly improved through systematic education, prompt troubleshooting, and high-quality service by physicians and device managers 9 . Various demographic and clinical predictors have yielded inconsistent results through many studies.…”

Section: Discussionmentioning

confidence: 99%

“…PAP maintains the patency of upper airway and helps to reduce the work of breathing and improve alveolar ventilation as well as hypoxemia 8 . The effect of PAP largely depends on the willingness of the patient to use the device during sleep since it is a self-administered therapy 9 . Therefore, adherence to the therapy should be considered as a major determinant for success of PAP therapy 10 .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Sleep time on back as a predictor of adherence to positive airway pressure therapy

Kwak,

Park,

Lee

et al. 2023

Sci Rep

Self Cite

View full text Add to dashboard Cite

Upper airway collapse can be effectively dealt with positive airway pressure (PAP), and patient adherence is considered as a major determining factor for success of PAP therapy. This study was performed to determine the potential factors affecting the adherence to PAP in patients with OSA by using polysomnography (PSG) parameters recorded for diagnosis of OSA. The data of 158 patients between December 2018 and July 2021 were collected. They were prescribed with PAP and used the device during the adaptation period for 90 days. They were categorized into adherent and non-adherent group according to the criteria of good adherence as use of PAP ≥ 4 h per night on 70% of nights. Demographic, clinical characteristics, and PSG results were reviewed. Among 158 patients engaged in PAP therapy, 121 patients (76.6%) met the criteria of good adherence. No significant differences were found in good adherence rate regarding demographic and clinical characteristics. None of the polysomnographic factors showed significant differences between adherent and non-adherent groups. However, the percentage of sleep time on back in the adherent group was significantly higher than non-adherent group (p = 0.041). The cut-off value was determined to be 41.45% (95% confidence interval 0.43 to 0.79) by receiver operating characteristic curve analysis and the odds ratio was calculated as 2.97. Only the percentage of sleep time on back appeared to be polysomnographic predictor for identifying good adherence to PAP therapy in OSA patients. However, the conclusions may be limited in generalization due to the small sample size.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sleep time on back as a predictor of adherence to positive airway pressure therapy

Kwak,

Park,

Lee

et al. 2023

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…On the other hand, it is reported that the PAP compliance rate has improved after the enforcement of the KNHI benefits for PAP compared to before. After analyzing the PAP data of 187 OSA patients who got PAP [19] found that 125 patients (66.8%) fulfilled the general PAP compliance rate (a case where the number of days using PAP for 4 hours or more a day is 70% or more of the total number of days using PAP) during the adaptation period of 90 days. The KNHI benefits for PAP started to be applied to the use of PAP for the treatment of OSA patients in Korea in July 2018.…”

Section: Discussionmentioning

confidence: 99%

Compliance After Re-Prescription for Positive Airway Pressure in Obstructive Sleep Apnea Patients Who Failed Positive Airway Pressure Therapy

et al. 2022

View full text Add to dashboard Cite

Background and Objectives: Little is known about studies evaluating positive airway pressure (PAP) compliance after re-prescription. Therefore, the aim of this study was to investigate PAP compliance after re-prescription in obstructive sleep apnea (OSA) patients who failed initial PAP therapy.Methods: We retrospectively reviewed OSA patients who had received a re-prescription for PAP from March 2020 to June 2021. We compared the compliance rate between initial prescription and re-prescription for PAP and investigated the reasons for PAP failure after the first prescription.Results: A total of 10 consecutive OSA patients (mean age=45.6±13.7 years and male:female=8:2) who received a re-prescription for PAP were included. Of them, 8 patients (80%) met the compliance criteria (i.e., Korean National Health Insurance criteria) for PAP after re-prescription. The compliance rate increased from 36.3±18.2% (initial prescription) to 61.3±28.8% (re-prescription); this was not of statistical significance (p=0.074). PAP/mask-related discomfort was the most common reason for PAP failure, followed by nasal obstruction, unintentional mask removal, and pressure-related discomfort.Conclusion: Even if initial PAP therapy fails, the proportion of patients who meet the compliance criteria may be improved through various forms of clinical aid and support after re-prescription of PAP.

show abstract

Current challenges and opportunities in global sleep medicine

2023

Encyclopedia of Sleep and Circadian Rhythms

View full text Add to dashboard Cite

Effect of National Health Insurance Coverage on Adherence to Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients

Cited by 3 publications

References 19 publications

Sleep time on back as a predictor of adherence to positive airway pressure therapy

Sleep time on back as a predictor of adherence to positive airway pressure therapy

Compliance After Re-Prescription for Positive Airway Pressure in Obstructive Sleep Apnea Patients Who Failed Positive Airway Pressure Therapy

Current challenges and opportunities in global sleep medicine

Contact Info

Product

Resources

About