Effects of intensive outpatient training on the adherence of CPAP therapy for patients with OSA

Nilius, Georg; Cottin, U.; Domanski, U; Hoog, T. van’t; Franke, KJ; Burian, S.; Ruehle, Karl-Heinz

doi:10.1007/s11818-012-0580-y

Cited by 9 publications

(9 citation statements)

References 39 publications

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“…In the five studies that added a combination of face-to-face and eHealth strategies, the eHealth component generally consisted of telephone calls designed to troubleshoot, provide support and encouragement, and reinforce CPAP treatment adherence. The face-to-face components mainly involved personal consultation for education, consultation, or early review [26][27][28][29], and one included a brief motivational enhancement program [30].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…No significant differences in CPAP adherence were found between studies investigating eHealth as an add-on to CAU (n=13) and studies investigating eHealth as a replacement of CAU (n=5) (see Multimedia Appendix 2 for an overview of both types of studies). A second subgroup analysis compared interventions providing eHealth only (n=11) [17,24,25,31,34,[36][37][38][39][40][41] with blended approaches combining eHealth and face-to-face strategies (n=5) [26][27][28][29][30]. Two studies [32,33] were excluded, because it was unclear whether collaborative management was provided using eHealth technology.…”

Section: Subgroup Analysis Of Ehealth Interventions and Continuous Positive Airway Pressure Adherencementioning

confidence: 99%

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Effectiveness of Electronic Health Interventions in Improving Treatment Adherence for Adults With Obstructive Sleep Apnea: Meta-Analytic Review

et al. 2020

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Background Poor adherence to continuous positive airway pressure (CPAP) treatment by adults with obstructive sleep apnea (OSA) is a common issue. Strategies delivered by means of information and communication technologies (ie, electronic health [eHealth]) can address treatment adherence through patient education, real-time monitoring of apnea symptoms and CPAP adherence in daily life, self-management, and early identification and subsequent intervention when device or treatment problems arise. However, the effectiveness of available eHealth technologies in improving CPAP adherence has not yet been systematically studied. Objective This meta-analytic review was designed to investigate the effectiveness of a broad range of eHealth interventions in improving CPAP treatment adherence. Methods We conducted a systematic literature search of the databases of Cochrane Library, PsycINFO, PubMed, and Embase to identify relevant randomized controlled trials in adult OSA populations. The risk of bias in included studies was examined using seven items of the Cochrane Collaboration risk-of-bias tool. The meta-analysis was conducted with comprehensive meta-analysis software that computed differences in mean postintervention adherence (MD), which was defined as the average number of nightly hours of CPAP use. Results The meta-analysis ultimately included 18 studies (N=5429 adults with OSA) comprising 22 comparisons between experimental and control conditions. Postintervention data were assessed at 1 to 6 months after baseline, depending on the length of the experimental intervention. eHealth interventions increased the average nightly use of CPAP in hours as compared with care as usual (MD=0.54, 95% CI 0.29-0.79). Subgroup analyses did not reveal significant differences in effects between studies that used eHealth as an add-on or as a replacement to care as usual (P=.95), between studies that assessed stand-alone eHealth and blended strategies combining eHealth with face-to-face care (P=.23), or between studies of fully automated interventions and guided eHealth interventions (P=.83). Evidence for the long-term follow-up effectiveness of eHealth adherence interventions remains undecided owing to a scarcity of available studies and their mixed results. Conclusions eHealth interventions for adults with OSA can improve adherence to CPAP in the initial months after the start of treatment, increasing the mean nightly duration of use by about half an hour. Uncertainty still exists regarding the timing, duration, intensity, and specific types of eHealth interventions that could be most effectively implemented by health care providers.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Subgroup Analysis Of Ehealth Interventions and Continuous Positive Airway Pressure Adherencementioning

confidence: 99%

Effectiveness of Electronic Health Interventions in Improving Treatment Adherence for Adults With Obstructive Sleep Apnea: Meta-Analytic Review

et al. 2020

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“…Three hundred and sixty-two potentially relevant publications were identified, from which 17 full text articles were reviewed with 12 being excluded 6,19,22,23,[27][28][29][30][31][32][33][34] as they did not match our inclusion criteria which is explained in Supplementary Material, File 4. Five papers fulfilled our inclusion criteria (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies did not have the facility for real-time tele-monitoring of CPAP, 6,19,22,23,29,34 though two retrieved the data at the end of the study. 6,23 This may have reduced the potential for the clinicians to detect real-time problems in remotely monitored participants such as poor/non adherence, poor mask fit/leak, and treatment efficacy that could have resulted in clinician intervention to resolve any detected problems.…”

Section: Discussionmentioning

confidence: 99%

“…Echoing the findings of this review, three of the teleconsultation RCTs showed no benefit in terms of adherence. 6,19,34 daytime sleepiness, 6 or quality of life. 6 In contrast, Sparrow et al., tested a telephone delivered theoretically based motivational intervention and showed a significant improvement in adherence, symptoms and functional status.…”

Section: Discussionmentioning

confidence: 99%

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Remote consulting with telemonitoring of continuous positive airway pressure usage data for the routine review of people with obstructive sleep apnoea hypopnoea syndrome: A systematic review

et al. 2017

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Introduction Telehealth has the potential to offer more convenient care and reduce travel. We aimed to systematically review studies that assessed the effectiveness of teleconsultation plus telemonitoring in the review of people with obstructive sleep apnoea hypopnoea syndrome receiving continuous positive airway pressure therapy versus face-to-face care. Methods Following Cochrane methodology, we searched 10 electronic databases (November 2015), trial registries, and reference lists of included studies, for trials testing interventions that combined remote consultations with telemonitoring of usage/continuous positive airway pressure data. Outcomes measures were: proportion reviewed, continuous positive airway pressure adherence, symptom control, and satisfaction/acceptability and cost effectiveness. Results From 362 potentially relevant papers, we identified five randomised controlled trials ( n = 269 patients): four from North America and one from Spain. Risk of bias was moderate in one, and moderate/high in four trials. Two trials reported number/duration of reviews with inconsistent results. The teleconsultation/telemonitoring improved continuous positive airway pressure adherence in two trials ( n = 19; n = 75); two ( n = 114 and n = 75) reported no between-groups differences. Two studies, both at moderate/high risk of bias, showed no between-group difference in the Epworth Sleepiness Score. Satisfaction was generally reported positively in all five trials; one trial reported that the teleconsultation/telemonitoring patients were 'more likely to continue' with continuous positive airway pressure therapy treatment. One study reported teleconsultation/telemonitoring as cost effective. Discussion The evidence for teleconsultation/telemonitoring in continuous positive airway pressure users is limited; however, no safety concerns have been raised. Adequately powered, well-designed trials are needed to establish whether real-time telemonitoring and remote teleconsultation is a clinically and cost effective option for people using continuous positive airway pressure therapy.

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Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea

Askland

Wright

Woźniak

et al. 2020

Cochrane Database of Systematic Reviews

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Effects of intensive outpatient training on the adherence of CPAP therapy for patients with OSA

Cited by 9 publications

References 39 publications

Effectiveness of Electronic Health Interventions in Improving Treatment Adherence for Adults With Obstructive Sleep Apnea: Meta-Analytic Review

Effectiveness of Electronic Health Interventions in Improving Treatment Adherence for Adults With Obstructive Sleep Apnea: Meta-Analytic Review

Remote consulting with telemonitoring of continuous positive airway pressure usage data for the routine review of people with obstructive sleep apnoea hypopnoea syndrome: A systematic review

Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea

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