Video Consultation as an Adequate Alternative to Face-to-Face Consultation in Continuous Positive Airway Pressure Use for Newly Diagnosed Patients With Obstructive Sleep Apnea: Randomized Controlled Trial

Kooij, Laura; Vos, Petra J.E.; Dijkstra, Ate; Roovers, Elisabeth A.; Harten, Wim H. van

doi:10.2196/20779

Cited by 8 publications

(9 citation statements)

References 46 publications

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“…Studies analyzing different telemedicine strategies for CPAP follow-up have found that CPAP compliance was equivalent to that with usual care (18,(25)(26)(27)(28). Only a few studies were successful in increasing CPAP compliance up to 30 min/night through phone coaching implementation (26 min/night) (29), or other methods .Nevertheless, a recent CPAP telemonitoring meta-analysis (22) did not find differences in CPAP compliance with telemonitored and standard CPAP follow-up.…”

Section: Discussionmentioning

confidence: 99%

Telemedicine home CPAP titration and follow-up in the COVID-19 scenario

et al. 2022

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Obstructive sleep apnea (OSA) is a highly prevalent chronic disease associated with important comorbidities such as traffic accidents, cardiovascular and metabolic diseases and mortality, among others [1]. Continuous positive airway pressure (CPAP), a first-line therapy in moderate-severe OSA [2], has been proven successful in improving daytime sleepiness, quality of life, reducing traffic accidents [3], improving hypertension and paroxistical atrial fibrillation [4, 5]. However, 47% of successfully titrated patients abandon treatment within three years [5, 6]. Thus, early OSA and CPAP education with close follow-up is mandatory to achieve satisfactory CPAP compliance [6, 7]. In that context, telemedicine and telemonitoring through remote monitoring CPAP have become promising strategies [8, 9]. Recently, smartphone applications [10] and wearables [11] have been added as new suggested tools for improving CPAP compliance.

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Section: Discussionmentioning

confidence: 99%

Telemedicine home CPAP titration and follow-up in the COVID-19 scenario

et al. 2022

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“…[104] There is increasing evidence that this approach is at least as effective as face-to-face reviews and may enable more timely management. In terms of service delivery, telemonitoring has been deemed feasible in a range of healthcare systems, [105][106][107][108] facilitating access to CPAP initiation, [105] promoting timely titration of therapy, [106,109,110] and troubleshooting of technical problems. [106,111] A meta-analysis (n=11 RCTs; 1440 patients) concluded that overall telemedicine improved adherence compared to centre-based care.…”

Section: Monitoring To Support Remote Consulting In Obstructive Sleep...mentioning

confidence: 99%

“…[108,110,113,114] Telemonitoring and video consultations (see Figure 4) are generally well accepted by patients using CPAP therapy. [103,[107][108][109][110][114][115][116] The time savings reduce the impact on work productivity and the reduced travel and fuel consumption costs are valued as environmentally friendly. [59] Remote monitoring to reduce exacerbations of COPD Key objectives of COPD telemonitoring are to reduce exacerbations (especially severe exacerbations resulting in distressing and costly admissions) and improve quality of life.…”

Section: Monitoring To Support Remote Consulting In Obstructive Sleep...mentioning

confidence: 99%

Telemedicine and virtual respiratory care in the era of COVID-19

Pinnock

Murphie²,

Vogiatzis

et al. 2022

ERJ Open Res

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The World Health Organization defines telemedicine as “an interaction between a health care provider and a patient when the two are separated by distance”. The COVID-19 pandemic has forced a dramatic shift to telephone and video consulting for follow up and routine ambulatory care for reasons of infection control. Short Message Service (“text”) messaging has proved a useful adjunct to remote consulting allowing transfer of photographs and documents. Maintaining non-communicable diseases care is a core component of pandemic preparedness and telemedicine has developed to enable (for example) remote monitoring of sleep apnoea, telemonitoring of chronic obstructive pulmonary disease, digital support for asthma self-management, remote delivery of pulmonary rehabilitation. There are multiple exemplars of telehealth instigated rapidly to provide care for people with COVID-19, to manage the spread of the pandemic, or to maintain safe routine diagnostic or treatment services.Despite many positive examples of equivalent functionality and safety, there remain questions about the impact of remote delivery of care on rapport and the longer-term impact on patient/professional relationships. Although telehealth has the potential to contribute to universal health coverage by providing cost-effective accessible care, there is a risk of increasing social health inequalities if the “digital divide” excludes those most in need of care. As we emerge from the pandemic, the balance of remote versus face-to-face consulting, and the specific role of digital health in different clinical and healthcare contexts will evolve. What is clear is that telemedicine in one form or another will be part of the “new norm”.

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“…Of these, 63 studies were retrieved for full-text review and assessment for eligibility. 51 studies did not meet the inclusion criteria and a total of 12 studies [22][23][24][25][26][27][28][29][30][31][32][33] were included in the review as outlined in the PRISMA flow diagram (figure 1). The commonest reason for exclusion was "wrong intervention" (n=16).…”

Section: Overview Of Eligible Studiesmentioning

confidence: 99%

“…Adherence to CPAP therapy CPAP therapy usage, assessed objectively, was reported by all included studies (n=12). The average CPAP usage at follow-up assessment ranged from 3.5 to 5.6 h per night with virtual consultations and 2.1 to Other bias TAYLOR et al [22] STEPNOWSKY et al [23] ISETTA et al [24] FRASNELLI et al [26] FIELDS et al [25] TURINO et al [27] LUGO et al [28] NILIUS et al [29] PÉPIN et al [30] TAMISIER et al [31] FIETZE et al [33] KOOIJ et al [32] Low risk of bias…”

Section: Secondary Outcomesmentioning

confidence: 99%

Virtual consultations for patients with obstructive sleep apnoea: a systematic review and meta-analysis

Alsaif

Kelly²,

Little³

et al. 2022

Eur Respir Rev

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BackgroundThe coronavirus disease 2019 pandemic has accelerated the adoption of virtual care strategies for the management of patients with obstructive sleep apnoea/hypopnoea syndrome (OSAHS).Research questionWhat is the effectiveness of virtual consultations compared to in-person consultations for the management of continuous positive airway pressure (CPAP) therapy in adult patients with OSAHS?MethodsA systematic review and meta-analysis (PROSPERO; CRD42022297532) based on six electronic databases plus manually selected journals was conducted in January 2022. Two researchers independently selected, quality appraised and extracted data. The co-primary outcomes were patient-reported sleepiness, assessed by the Epworth Sleepiness Scale (ESS), and reported cost-effectiveness.Results12 studies (n=1823 adults) were included in the review. Seven studies (n=1089) were included in the meta-analysis which showed no difference in the magnitude of improvement in patient-reported sleepiness scores between virtual and in-person consultations (mean difference −0.39, 95% CI −1.38–0.60; p=0.4), although ESS scores improved in both groups. Virtual care strategies modestly increased CPAP therapy adherence and were found to be less costly than in-person care strategies in the three Spanish trials that reported cost-effectiveness.ConclusionThe findings of this review suggest that virtual care delivered by telephone or video consultations is as effective as in-person consultations for improving subjective sleepiness in patients with OSAHS treated with CPAP. This clinical management strategy may also improve CPAP adherence without increasing the costs, supporting its potential as a follow-up management strategy, where patients prefer this approach.

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Video Consultation as an Adequate Alternative to Face-to-Face Consultation in Continuous Positive Airway Pressure Use for Newly Diagnosed Patients With Obstructive Sleep Apnea: Randomized Controlled Trial

Cited by 8 publications

References 46 publications

Telemedicine home CPAP titration and follow-up in the COVID-19 scenario

Telemedicine home CPAP titration and follow-up in the COVID-19 scenario

Telemedicine and virtual respiratory care in the era of COVID-19

Virtual consultations for patients with obstructive sleep apnoea: a systematic review and meta-analysis

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