Management of continuous positive airway pressure treatment compliance using telemonitoring in obstructive sleep apnoea
Open accessAbstract
Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnoea (OSA), but treatment compliance is often unsatisfactory. This study investigated the efficacy and cost-effectiveness of telemonitoring for improving CPAP compliance. 100 newly diagnosed OSA patients requiring CPAP (apnoea–hypopnoea index >15 events·h −1 ) were randomised to standard management or a telemonitoring programme that collected daily information about compliance, air leaks and residual respiratory events, and initiated patient contact to resolve issues. Clinical/anthropometric variables, daytime sleepiness and quality of life were recorded at baseline and after 3 months. Patient satisfaction, additional visits/calls, side-effects and total costs were assessed. There were no significant differences between the standard and telemedicine groups in terms of CPAP compliance (4.9±2.2 versus 5.1±2.1 h·night −1 ), symptoms, clinical variables, quality of life and unwanted effects. Telemedicine was less expensive than standard management (EUR123.65 versus EUR170.97; p=0.022) and was cost-effective (incremental cost-effectiveness ratio EUR17 358.65 per quality-adjusted life-year gained). Overall patient satisfaction was high, but significantly more patients rated satisfaction as high/very high in the standard management versus telemedicine group (96% versus 74%; p=0.034). Telemonitoring did not improve CPAP treatment compliance and was associated with lower patient satisfaction. However, it was more cost-effective than traditional follow-up.
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In the other RCT study, participants in the telemonitoring group reported low to moderate overall satisfaction compared to those in the usual care arm (26% versus 4% respectively) with additional concerns about privacy when being identified as being nonadherent or that non-hospital personnel had access to their PAP data.
“In the other RCT study, participants in the telemonitoring group reported low to moderate overall satisfaction compared to those in the usual care arm (26% versus 4% respectively) with additional concerns about privacy when being identified as being nonadherent or that non-hospital personnel had access to their PAP data.”
From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [235]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured63% of those in the telemonitoring arm placed a high or very high value on the usefulness of the telemonitoring assessment.
“Despite this, 63% of those in the telemonitoring arm placed a high or very high value on the usefulness of the telemonitoring assessment.235”
From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [235]
The Results and Discussion (page unavailable) say that patients in the telemonitoring arm generally valued the programme positively, including its usefulness. Our copy does not give the claimed 63% or the “high or very high” rating; Table 3’s data rows are absent from the indexed text. (LLM, conf=0.82)
Experimental — accuracy not yet measuredPatient satisfaction with telemonitoring-guided adherence interventions was assessed in two of the reviewed studies, with discrepant findings.
“Patient satisfaction with telemonitoring guided adherence interventions was assessed in two of the reviewed studies, with discrepant findings.232,235”
Two RCTs assessed the impact of telemonitoring-guided PAP adherence interventions on PAP-induced side effects, but data were not reported in a sufficiently standardized format to allow for meta-analysis.
“Two RCTs were identified that assessed the impact of a telemonitoring guided PAP adherence intervention on PAP-induced side effects; however, data were not reported in a sufficiently standardized format to allow for a meta-analysis.228,235”
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References 26 · Cited by 115
- Authors
- Turino, C., de Batlle, J., Woehrle, H., Mayoral, A., Castro-Grattoni, A. L., Gómez, S., Dalmases, M., Sánchez-de-la-Torre, M., & Barbé, F.
- Affiliations
- Hospital Universitari Arnau de Vilanova (ES)
- ResMed (Germany) (DE)
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2017-02
- Volume
- 49
- Issue
- 2
- Pages
- 1601128
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2587303477
- Semantic Scholar
- cf449c235b379b7df24cf619f095521f7ccc5b5e
- Cited by
- 115
- References
- 26
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 14 · 2023: 15 · 2022: 19 · 2021: 17 · 2020: 15 · 2019: 16 · 2018: 1 · 2017: 4
- FWCI
- 7.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- RUIdeRA - Institutional University Repository (University of Castilla-La Mancha) (submittedVersion, other-oa)
- Funders
- Associació Lleidatana de Respiratori
- ResMed Foundation
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- obstructive sleep apnea, continuous positive airway pressure, CPAP adherence, remote patient monitoring, telemedicine, cost-effectiveness, patient satisfaction, daytime sleepiness, quality of life, air leakage, follow-up care
- MeSH terms
- Adult, Aged, Cost-Benefit Analysis, Female, Humans, Male, Middle Aged, Patient Compliance, Prospective Studies, Quality of Life, Spain, Logistic Models, Treatment Outcome, Patient Satisfaction, Telemedicine, Quality-Adjusted Life Years, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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