Positive airway pressure telehealth models and long-term therapy termination: a healthcare database analysis.

Background

Telemonitoring-guided interventions can improve short-term positive airway pressure (PAP) therapy adherence, but long-term effects are unknown. This study investigated long-term PAP therapy termination in patients with sleep apnoea managed with standard care, telemonitoring-guided proactive care or telemonitoring-guided proactive care + patient engagement tool.

Methods

German healthcare provider data were analysed retrospectively. Individuals aged 18-100 years who started PAP from 2014 to 2019 and had device type/interface data were included. Time-to-termination periods were analysed using Kaplan-Meier plots and Cox proportional hazards regression, adjusted for age, sex, insurance type, and device and mask type.

Results

The per-protocol population (valid telemonitoring data) included 104 612 individuals (71% male; 95% aged >40 years). Mean follow-up was 3.3±2.0 years. The overall therapy termination rate was significantly lower in the telemonitoring-guided proactive care group

Conclusions

Use of telemonitoring-guided proactive care and a patient engagement tool was associated with lower rates of PAP therapy termination.

Informations de copyright

Copyright ©The authors 2024.

Déclaration de conflit d'intérêts

Conflict of interest: H. Woerhle has received lecture/consulting fees from AstraZeneca, Allergopharma, Bioprojet, Boehringer Ingelheim, Chiesi, GSK, Novartis, Inspire, Jazz and ResMed, and research support from ResMed and Novartis. Conflict of interest: C. Schoebel has received grants from AstraZeneca, ResMed and Bayer, consulting fees from ResMed, Idorsia, Bristol-Myers Squibb and Astra Zeneca, and honoraria/lecture fees from Berlin Chemie, Takeda and Mementor; he also has unpaid roles as treasurer of the German Sleep Society, head of the Telemedicine Working Group of the German Society for Internal Medicine, and treasurer of the Sleep Apnea Working Group of the German Cardiac Society. Conflict of interest: J.H. Ficker has received grants and personal/lecture fees from ResMed and Inspire. Conflict of interest: A. Graml and J. Schnepf are employees of ResMed. Conflict of interest: I. Fietze reports support and grants from ResMed and Löwenstein Medical, personal fees from ResMed and Bioprojet, and has an unpaid role as director of the German Sleep Foundation. Conflict of interest: P. Young reports personal fees from Sanofi Genzyme, Biomarin, UCB Pharma, Medice, ResMed, Löwenstein Medical and Vanda, and grants from Lowensteinstiftung and the German Ministry of Education and Science (BMBF). Conflict of interest: M. Arzt has received grant support from ResMed, the ResMed Foundation, Philips Respironics and the Else-Kroehner Fresenisus Foundation, and lecture and/or consulting fees from ResMed, WITA Italia and Philips Respironics.