Web-Based Access to Positive Airway Pressure Usage with or without an Initial Financial Incentive Improves Treatment Use in Patients with Obstructive Sleep Apnea

Kuna, Samuel T.; Shuttleworth, D.; Chi, Luqi; Schutte-Rodin, Sharon; Friedman, Eliot; Guo, Hengyi; Dhand, Sandeep; Yang, Lin; Zhu, Jingsan; Bellamy, Scarlett L.; Volpp, Kevin G.; Asch, David A.

doi:10.5665/sleep.4898

Cited by 89 publications

(74 citation statements)

References 40 publications

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“…The positive impact of patient involvement in therapy was highlighted in a recent study which showed that providing patients with web-based access to their personal PAP usage data increased device usage in the first week of therapy and over 3 months of follow-up compared with usual care [26]. …”

Section: Discussionmentioning

confidence: 99%

Telemedicine-based proactive patient management during positive airway pressure therapy

et al. 2017

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BackgroundAdherence to positive airway pressure (PAP) therapy is essential for the benefits of therapy to be realised. Telemedicine-based strategies provide a new option for enhanced monitoring and intervention to promote adherence during PAP. This study investigated the impact of telemedicine-based proactive patient management on PAP therapy termination rates versus standard care.MethodsObservational data were obtained from ResMed Germany Healthcare, a German homecare provider. Patients were undergoing routine homecare using either a standard or proactive management strategy. The proactive strategy used data from AirView™, a cloud-based remote monitoring system, to prompt patient contact and information sharing/education. Patients receiving their first PAP therapy were included and analysed in matched pairs.ResultsIn all, 3401 patients were included in each group. In the first year of PAP therapy, overall therapy termination rate was significantly lower (5.4% vs 11.0%; p < 0.001) and time to therapy termination was significantly longer (348 ± 58 vs 337 ± 76 days; p < 0.05) in the proactive versus standard care group. Cox proportional hazard analysis revealed a significantly reduced risk of PAP termination in the proactive versus the standard care group (hazard ratio 0.48, 95% confidence interval 0.4–0.57). Findings were consistent in subanalyses according to gender, type of device and insurance status, and in patients aged ≥40 years. However, in the subgroup of patients aged younger than 40 years, the risk of PAP termination was similar in the proactive and standard groups.ConclusionA telemedicine-based proactive management strategy compared with standard care of PAP patients was associated with a lower long-term therapy termination rate.

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Section: Discussionmentioning

confidence: 99%

Telemedicine-based proactive patient management during positive airway pressure therapy

et al. 2017

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“…Average PAP use was 4.7 ± 3.3 h in the usual care group and 5.9 ± 2.5 and 6.3 ± 2.5 h in the web‐based access to PAP usage groups with and without financial incentive. Functional Outcomes of Sleep Questionnaire (FOSQ) scores at 3 months improved with statistical significance in all three groups, but the change in FOSQ scores of web‐based access to PAP usage groups were not different from the control group . Fox et al .…”

Section: Tm Adherence and Progress Of Cpap‐treated Osa Syndrome Patientsmentioning

confidence: 97%

Does remote monitoring change OSA management and CPAP adherence?

et al. 2017

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It is increasingly recognized that the high prevalence of obstructive sleep apnoea (OSA), and its associated cardio-metabolic morbidities make OSA a burden for society. Continuous positive airway pressure (CPAP), the gold standard treatment, needs to be used for more than 4 h/night to be effective, but suffers from relatively poor adherence. Furthermore, CPAP is likely to be more effective if combined with lifestyle changes. Thus, the remote telemonitoring (TM) of OSA patients in terms of CPAP use, signalling of device problems, following disease progression, detection of acute events and monitoring of daily physical activity is an attractive option. In the present review, we aim to summarize the recent scientific data on remote TM of OSA patients, and whether it meets expectations. We also look at how patient education and follow-up via telemedicine is used to improve adherence and we discuss the influence of the profile of the healthcare provider. Then, we consider how TM might be extended to encompass the patient's cardio-metabolic health in general. Lastly, we explore how TM and the deluge of data it potentially generates could be combined with electronic health records in providing personalized care and multi-disease management to OSA patients.

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“…Kuna et al [34] randomized 138 recently diagnosed OSAS patients requiring CPAP, to usual care, usual care with access to CPAP usage, or usual care with access to CPAP usage and a financial incentive. After three months, mean adherence was 4.8 and 5 h/night in the intervention groups vs. 3.8 for usual care ( p < 0.0001).…”

Section: Telemonitoring Of Cpap-treated Obstructive Sleep Apnea Symentioning

confidence: 99%

Technical Developments and Clinical Use of Telemedicine in Sleep Medicine

Bruyneel

2016

JCM

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The use of assistive technology and telemedicine is likely to continue to shape our medical practice in the future, notably in the field of sleep medicine, especially within developed countries. Currently, the number of people suffering from obstructive sleep apnea syndrome (OSAS) is increasing. Telemedicine (TM) can be used in a variety of ways in sleep medicine: telediagnostics, teleconsultation, teletherapy and telemonitoring of patients being treated with positive pressure devices. In this review, we aim to summarize the recent scientific progresses of these techniques and their potential clinical applications and give consideration to the remaining problems related to TM application.

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Web-Based Access to Positive Airway Pressure Usage with or without an Initial Financial Incentive Improves Treatment Use in Patients with Obstructive Sleep Apnea

Abstract: Positive airway pressure adherence is significantly improved by giving patients Web access to information about their use of the treatment. Inclusion of a financial incentive in the first week had no additive effect in improving adherence.

Cited by 89 publications

References 40 publications

Telemedicine-based proactive patient management during positive airway pressure therapy

Telemedicine-based proactive patient management during positive airway pressure therapy

Does remote monitoring change OSA management and CPAP adherence?

Technical Developments and Clinical Use of Telemedicine in Sleep Medicine

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