Medication Adherence and Persistence in Severe Obstructive Sleep Apnea

Villar, Isabel; Izuel, M.; Carrizo, Santiago; Vicente, Eugenio Fernández; Marı́n, José Marı́a

doi:10.1093/sleep/32.5.623

Cited by 60 publications

(36 citation statements)

References 32 publications

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“…They found no difference in the rates of medication adherence between the two groups, suggesting that nonadherence to CPAP does not necessarily imply nonadherence to pharmacotherapy. Th e present fi ndings are in line with Villar et al 42 and reinforce the notion that untreated moderate-severe OSA may be an independent risk factor for repeat revascularization aft er PCI. Another limitation was that CPAP adherence was based on subjective patient report rather than on objective adherence data obtained from the CPAP devices.…”

Section: Discussionsupporting

confidence: 92%

“…Th e strategy of reviewing pharmacy records for prescription refi lls as a marker of medication adherence has been well described in the cardiovascular literature. 41 Villar et al 42 examined adherence to cardiovascular medications (ie, antihypertensive, lipid-lowering, and antiplatelet drugs) in two groups of patients with severe OSA and cardiovascular disease: those who were adherent to CPAP treatment and those who refused treatment or were nonadherent to CPAP. They found no difference in the rates of medication adherence between the two groups, suggesting that nonadherence to CPAP does not necessarily imply nonadherence to pharmacotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of OSA Reduces the Risk of Repeat Revascularization After Percutaneous Coronary Intervention

Liu

et al. 2015

Chest

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Treatment of OSA Reduces the Risk of Repeat Revascularization After Percutaneous Coronary Intervention

Liu

et al. 2015

Chest

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“…However, these differences cannot be statistically confirmed because of the time‐dependent study design and absence of independent observations, though the observed differences seem substantial. Adherence to medical treatment in patients with SA has been investigated in a cohort of 2158 patients with severe OSA; in this study the authors found high medication adherence among all patients and, remarkably, no difference in medication adherence between patients adherent and nonadherent to CPAP therapy 27. This supports our findings of CPAP therapy possibly playing an active role in reducing the risk of developing HF in SA patients.…”

Section: Discussionsupporting

confidence: 85%

Sleep Apnea, the Risk of Developing Heart Failure, and Potential Benefits of Continuous Positive Airway Pressure (CPAP) Therapy

Holt

Bjerre

Zareini

et al. 2018

JAHA

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BackgroundWhether there is an association between sleep apnea (SA) and the risk of developing heart failure (HF) is unclear. Furthermore, it has never been established whether continuous positive airway pressure (CPAP) therapy can prevent development of HF. We aimed to investigate SA patients’ risk of developing HF and the association of CPAP therapy.Methods and ResultsUsing nationwide databases, the entire Danish population was followed from 2000 until 2012. patients with SA receiving and not receiving CPAP therapy were identified and compared with the background population. The primary end point was first‐time hospital contact for HF and adjusted incidence rate ratios of HF were calculated using Poisson regression models. Among 4.9 million individuals included, 40 485 developed SA during the study period (median age: 53.4 years, 78.5% men) of whom 45.2% received CPAP therapy. Crude rates of HF were increased in all patients with SA relative to the background population. In the adjusted model, the incidence rate ratios of HF were increased in the untreated SA patients of all ages, compared with the background population. Comparing the CPAP‐treated patients with SA with the untreated patients with SA showed significantly lower incidence rate ratios of HF among older patients.ConclusionsIn this nationwide cohort study, SA not treated with CPAP was associated with an increased risk of HF in patients of all ages. Use of CPAP therapy was associated with a lower risk of incident HF in patients >60 years of age, suggesting a protective effect of CPAP therapy in the elderly.

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“…It is reported that patients not accepting CPAP have the same high compliance with drugs for elevated cholesterol, for reducing hypertension, etc. 44 We conclude that CPAP treatment is associated with lower mortality rates in males with OSA, including the middle-aged and elderly (aged $60 years). However, we found no significant effect on all-cause mortality of CPAP treatment in female OSA patients.…”

Section: Discussionmentioning

confidence: 70%

All-cause mortality from obstructive sleep apnea in male and female patients with and without continuous positive airway pressure treatment: A registry study with 10 years of follow-up

Jennum

Tønnesen

Ibsen³

et al. 2015

Sleep Medicine

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Background: More information is needed about the effect on mortality of continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA), especially in women. Methods:We employed a historical cohort study design, using data from 25,389 patients with a diagnosis of OSA selected from the Danish National Patient Registry for the period 1999-2009. We used Cox proportional hazard function to evaluate the all-cause mortality from OSA in middle-aged and elderly males and females who were treated, or not, with CPAP. Results: Female OSA patients had a lower mortality than males, irrespective of whether they received CPAP treatment. CPAP treatment improved survival, as illustrated by the hazard ratio of 0.62 (P,0.001). This effect was dependent on gender: CPAP had no significant effect on 20-to 39-year-old males and females, but the overall mortality in this age group was small. Survival was increased by CPAP in 40-to 59-year-old and $60-year-old males, but no such effect was observed in females. Positive predictors of survival were young age, female gender, higher educational level, and low 3-year prior comorbidity as estimated by the Charlson Comorbidity Index. Negative predictors for survival were male gender, age $60 years, no CPAP treatment, prior comorbidity, and low educational level. Conclusion: CPAP therapy is associated with reduced all-cause mortality in middle-aged and elderly males, but no significant effect was found in females.

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Medication Adherence and Persistence in Severe Obstructive Sleep Apnea

Abstract: Medication adherence and persistence during a 2-year period for 3 well-known protective cardiovascular medications were not different in patients with severe OSA, whether or not they were treated with CPAP.

Cited by 60 publications

References 32 publications

Treatment of OSA Reduces the Risk of Repeat Revascularization After Percutaneous Coronary Intervention

Treatment of OSA Reduces the Risk of Repeat Revascularization After Percutaneous Coronary Intervention

Sleep Apnea, the Risk of Developing Heart Failure, and Potential Benefits of Continuous Positive Airway Pressure (CPAP) Therapy

All-cause mortality from obstructive sleep apnea in male and female patients with and without continuous positive airway pressure treatment: A registry study with 10 years of follow-up

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