Michael Stanchina1,2,3,4, Julie Lincoln4, Susan Prenda4, Molly Holt1, Ingrid Leon1, Walter Donat1,2, William Corrao1,2,3, Elias Jabbour1,2, Seth Koenig2, Atul Malhotra5. 1. Brigham and Women's Pulmonary at CNE, East Greenwich, Rhode Island. 2. Kent Hospital, East Greenwich, Rhode Island. 3. Alpert School of Medicine at Brown University, Providence, Rhode Island. 4. Epoch Sleep Centers, Providence, Rhode Island. 5. Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, California.
Abstract
STUDY OBJECTIVES: The impact of direct mail order sales of positive airway pressure (PAP) devices, accentuated by the coronavirus disease 2019 (COVID-19) pandemic, on PAP adherence in patients with obstructive sleep apnea remains unclear. In this study we compared the impact of different modes of continuous positive airway pressure delivery on adherence and daytime symptoms. We hypothesized that adherence would not be affected by remote PAP setup, aided by telehealth technology. METHODS: Three groups were studied: 1) standard group PAP setup (3-4 people); 2) direct home shipment of PAP, followed by telehealth interactions; 3) direct home shipment of PAP, during the COVID-19 pandemic where delivery choice was removed. Demographics, sleepiness, PAP data, and insurance information were also compared. RESULTS: A total of 666 patients were studied in 3 groups. 1) Standard group PAP setup had 225 patients and adherence with PAP (% of nights used more than 4 hours) was 65.3 ± 2.1%. 2) Direct home shipment of PAP group had 231 patients, and adherence was 54.2 ± 2.4%. 3) Direct mailed PAP units during the COVID-19 pandemic group had 210 patients, and adherence was 55.9 ± 2.5%. Adherence was lower in both groups receiving home shipments compared to those in groups in-center (analysis of variance, Tukey, P = .002). Discontinuation of PAP was less in the in-center group setup patients (χ2 = 10.938 P ≤ .001). CONCLUSIONS: Patients receiving direct home PAP shipments had lower adherence and were more likely to discontinue PAP compared to standard in-person setup. CITATION: Stanchina M, Lincoln J, Prenda S, et al. The impact of different CPAP delivery approaches on nightly adherence and discontinuation rate in patients with obstructive sleep apnea. J Clin Sleep Med. 2022;18(8):2023-2027.
STUDY OBJECTIVES: The impact of direct mail order sales of positive airway pressure (PAP) devices, accentuated by the coronavirus disease 2019 (COVID-19) pandemic, on PAP adherence in patients with obstructive sleep apnea remains unclear. In this study we compared the impact of different modes of continuous positive airway pressure delivery on adherence and daytime symptoms. We hypothesized that adherence would not be affected by remote PAP setup, aided by telehealth technology. METHODS: Three groups were studied: 1) standard group PAP setup (3-4 people); 2) direct home shipment of PAP, followed by telehealth interactions; 3) direct home shipment of PAP, during the COVID-19 pandemic where delivery choice was removed. Demographics, sleepiness, PAP data, and insurance information were also compared. RESULTS: A total of 666 patients were studied in 3 groups. 1) Standard group PAP setup had 225 patients and adherence with PAP (% of nights used more than 4 hours) was 65.3 ± 2.1%. 2) Direct home shipment of PAP group had 231 patients, and adherence was 54.2 ± 2.4%. 3) Direct mailed PAP units during the COVID-19 pandemic group had 210 patients, and adherence was 55.9 ± 2.5%. Adherence was lower in both groups receiving home shipments compared to those in groups in-center (analysis of variance, Tukey, P = .002). Discontinuation of PAP was less in the in-center group setup patients (χ2 = 10.938 P ≤ .001). CONCLUSIONS: Patients receiving direct home PAP shipments had lower adherence and were more likely to discontinue PAP compared to standard in-person setup. CITATION: Stanchina M, Lincoln J, Prenda S, et al. The impact of different CPAP delivery approaches on nightly adherence and discontinuation rate in patients with obstructive sleep apnea. J Clin Sleep Med. 2022;18(8):2023-2027.
Authors: Emerson M Wickwire; Sophia L Jobe; Liesl M Oldstone; Steven M Scharf; Abree M Johnson; Jennifer S Albrecht Journal: Sleep Date: 2020-12-14 Impact factor: 5.849
Authors: Martha E Billings; Dennis Auckley; Ruth Benca; Nancy Foldvary-Schaefer; Conrad Iber; Susan Redline; Carol L Rosen; Phyllis Zee; Vishesh K Kapur Journal: Sleep Date: 2011-12-01 Impact factor: 5.849
Authors: Peter A Cistulli; Jeff Armitstead; Jean-Louis Pepin; Holger Woehrle; Carlos M Nunez; Adam Benjafield; Atul Malhotra Journal: Sleep Med Date: 2019-01-11 Impact factor: 3.492
Authors: Nick A Antic; Catherine Buchan; Adrian Esterman; Michael Hensley; Matthew T Naughton; Sharn Rowland; Bernadette Williamson; Samantha Windler; Simon Eckermann; R Doug McEvoy Journal: Am J Respir Crit Care Med Date: 2009-01-08 Impact factor: 21.405
Authors: Terri E Weaver; Greg Maislin; David F Dinges; Thomas Bloxham; Charles F P George; Harly Greenberg; Gihan Kader; Mark Mahowald; Joel Younger; Allan I Pack Journal: Sleep Date: 2007-06 Impact factor: 5.849