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Randomized Controlled Trial
. 2024 Aug;28(4):1715-1721.
doi: 10.1007/s11325-024-03042-z. Epub 2024 May 16.

Effectiveness of remote monitoring in improving CPAP compliance and the impact of preexisting organisation of standard care: a randomised controlled trial

Stephan van der Kleij  1   2 , Ingrid de Backer  3 , Barbara Hanraets  3   4 , Johan Verbraecken  5 , Jerryll Asin  6
Affiliations
Randomized Controlled Trial

Effectiveness of remote monitoring in improving CPAP compliance and the impact of preexisting organisation of standard care: a randomised controlled trial

Stephan van der Kleij et al. Sleep Breath. 2024 Aug.

Abstract

PURPOSE : Continuous positive airway pressure (CPAP) is often the treatment of choice for obstructive sleep apnea (OSA). Short-term adherence and early perceived benefits are the best predictors of long-term adherence. The aim of this study was to determine the effect of telemonitoring in the first period of treatment with CPAP (auto-titrating PAP) on compliance and the long-term outcome.

Methods: Patients aged between 18-75 years old with symptomatic severe OSA (apnea-hypopnea index (AHI) ≥ 30) requiring CPAP therapy were included in this single-blind, single-centre, randomised, controlled trial. They were divided into 2 groups (telemonitored standard clinical care versus standard clinical care without telemonitoring).

Results: A total of 230 patients (115 patients/group) were included (mean age 54 ± 16.6 years, BMI 32.6 ± 5.4 kg/m2, ESS 13.1 ± 6.2, AHI 47.5 ± 14.8/hr). At week 10 compliance was similar in both groups (telemonitoring vs control 6:27 and 6:35 h, respectively, p = 0.57), as were AHI (2.4; 2.4/hr, p = 0.89) and ESS (5.8; 4.9, p = 0.22). The number of contacts of a patient with a healthcare professional was significantly higher during the follow-up from week 3 until week 10 (0.25; 0.13, p = 0.03). The number of patients who could be evaluated after 1 year was equally distributed in both groups (104; 104, p = 1.00), as were compliance (6:43; 6:49 h, p = 0.59) and residual AHI (1.9; 2.2/hr, p = 0.41).

Conclusions: In patients with severe OSA with standard intensive follow-up during the initial weeks of CPAP therapy and good compliance, telemonitoring did not improve CPAP compliance nor the clinical outcome in the short or long term. The practical consequences can be highly relevant for patients and healthcare professionals.

Keywords: Compliance; Obstructive sleep apnea; Positive airway pressure; Telemedicine; Telemonitoring/remote monitoring.

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Conflict of interest statement

S. van der Kleij, J Asin, I. de Backer and B. Hanraets certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

J. Verbraecken certifies that he has received funding in the last three years from AirLiquide, AstraZen, Bioprojet, Desitin, Epilog, Fisher & Paykel, Heinen & Löwenstein, Idorsia, Inspire, Medidis, Mediq Tefa, OSG, Philips, ResMed, SD Worx, Sefam, SomnoMed, Total Care, Vivisol, Westfalen Medical, Withings provided financial support in the form of 80700 € funding (honoraria, educational grants, consultancies). The sponsor had no role in the design or conduct of the research.

Figures

Fig. 1
Fig. 1
Decision tree for intervention during telemonitoring based on compliance, mask leakage and AHI which could be indicated independent of each other
Fig. 2
Fig. 2
Inclusion flowchart
See this image and copyright information in PMC

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References

    1. Weaver TE, Sawyer AM (2010) Adherence to continuous positive airway pressure treatment for obstructive sleep apnoea: implications for future interventions. Indian J Med Res 131:245–258 - PMC - PubMed
    1. Kushida A et al (2005) Practice Parameters for the Indications for Polysomnography and Related Procedures: An Update for 2005. Sleep 28(4):299–519 - PubMed
    1. Kendzerska T et al (2014) Obstructive sleep apnea and incident diabetes. A historical cohort study. Am J Respir Crit Care Med 190(2):218–25 10.1164/rccm.201312-2209OC - DOI - PubMed
    1. Lacasse Y, Godbout C, Sériès F (2002) Health-related quality of life in obstructive sleep apnoea. Eur Respir J 19(3):499–503 10.1183/09031936.02.00216902 - DOI - PubMed
    1. Weaver T et al (1999) Improvement in affect after 3 mo. CPAP: Multi-center study. Am J Respir Crit Care Med 159(3):A770–A770

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