Virginia Research Day 2021

CAN PATIENT COMPLIANCE WITH CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) BE IMPROVED? Andrew Wyker, DO, Mary Mondul, R.EEG T, RPSGT, Kimberly Bird, MD Sovah Internal Medicine Residency Program, Danville, VA

RR-6

Materials and Methods: A retrosp ec� ve s tudy was do n e c omparing CP AP c ompliance bet w een pa �en ts ini� a �ng C P AP with st anda r d f ollow up a t an Ameri c an A cade my of Sleep Medicine (AA SM) accr edi t ed Sleep Ce n ter in 2018 versus thos e a n e w t eam managemen t and o nline c loud -base d learning pr og r am added to st anda rd serial f ollow - up visits . Pa �en ts wer e selec t ed a t r and o m fr om li s ts of p a �en ts r equiring C PAP fr om 2018 and 2019 . The clo ud-base d p r og r am u�li z ed C P AP Sleep Coaches and R espi ratory Ther api sts who co n tact ed p a �en ts a t d ay s 3, 7, 14, 30, 45, 60, and 90 a �er st ar�ng C P AP t o p r omo t e p a �en t c ompliance. Compliance w as d e fined b y the Cen t er f or Me d i car e Se r vices d e fini�on w hich includ e C PAP usa ge a t lea s t 4 ho ur s a nig h t 70% of th e �me.

Introduc�on: Adjus �ng to CP AP f or o bs truc� v e slee p apne a takes e ffort and li fes tyle chang es. It is es �m ated tha t 50% of sleep apnea p a �ents pr escribed C P AP a r e n o n -c ompliant w ith pr escribed the rapy on e y ear l ater . M u l�ple strat egies hav e been used to imp rov e c ompliance including smaller and qui eter CP AP machines, diff ere n t mask t y pes and s i z es, he ated humidifi ca �on, mobile appli ca �ons, and fl e xible e xpi ratory pressures. With inc rease d c ompliance, p a �en ts ben e fit fr om b e �er sleep, imp rov ed medi c al c on d i�ons such a s hypert ensi o n and d iab et es, and lo w er risk of car di ov ascular diso rder s, c ance r , and ul�m at ely mor t alit y.

AASM Traditional Method

Cloud-Based Method

Results: Ther e wer e 86 pa �ents in the 2018 c o n tr ol g roup and 86 pa �en ts in t h e 2019 in terve n�onal g roup . In the 2018 g roup , 36 had mild slee p apnea, 26 had m oderate and 24 had severe. In t h e 2019 g roup , 25 had mild s leep apnea, 16 had mode rat e, and 45 had severe. Nin ety-day c ompliance betw een the 2018 and 2019 g r oups wer e 63.9% and 43 . 0% respe c� v el y , p v alue 0.005929.

Conclusion: Dat a rev ealed th a t st anda r d cl ose f ollow up with an AASM accr edi t ed Sleep Cen ter r esul t ed in c ompliance th a t was nonin f erior to t eam online c loud -base d learning p r og r am app roach. P re viou s s tudies of the cloud -base d management app r oach rev ealed an o ver all 24% inc rease in c ompliance when u�li z ed b y all phy sicians. Pa �en ts treat ed f or sleep apnea b y prim ary care phy sicians m a y ben e fit the mo s t f r om the c loud -base d p r og r am as c ompa r ed t o th o se managed b y sleep speciali sts. A pote n�al fact or in the study’s outc ome was the lack of succes s ful pa �ent co n t act during the fi rs t w eek in the cloud -base d int erve n�on g roup . In ad d i�on, b o th g r oups had p a �ents lo s t t o f ollow up a �er ini� a �on o f C PAP .

19

2 0 2 1 R e s e a r c h R e c o g n i t i o n D a y