P013 Continuous Positive Airways Pressure (CPAP) Adherence in Remote Patients using Telemedicine Model of Care

Abstract

Abstract Background CPAP is an established first-line treatment for moderate-to-severe OSA. Adherence is universally low and is predicted by short-term adherence. Moderate-to-severe OSA is strongly associated with adverse cardiovascular outcomes. Evidence of CPAP benefit is limited to underpowered subgroups with arbitrarily defined "good adherence". Covid-19 has generated widespread acceptance and uptake of telemedicine. This study aims to determine if CPAP adherence is affected when health service is provided by telemedicine rather than in-person. Methods Single-centre, retrospective, cohort study of moderate-to-severe OSA patients identified between 1/6/21 and 30/6/22. Medical records were reviewed for residential address, referral pathway (face-to-face or telemedicine), age, gender, BMI, ESS, AHI and AI. Short-term adherence was determined from CPAP downloads. Progress to date 368 patients were identified, 40% had moderate-to-severe OSA. 31.5% were reviewed by telemedicine (64% remote, 36% local). Compared to in-person, remote telemedicine cohort was similar age (age ≥ 50, 64.9% vs 53.2%, p= 0.075) but more likely male (66.2% vs 50%, p= 0.014). ESS (9.7 ± 1.4 vs 9.1 ± 0.7, p= 0.38), BMI (36.1 ± 2.5 vs 33.5 ± 1.3, p= 0.08), AHI (27.5 ± 7.5 vs 21.7 ± 3.4, p= 0.12) and presence of moderate-to-severe OSA (48.6% vs 42.5%, p= 0.35) were similar. Patient subgroups including local, remote, telemedicine and face-to-face reviews were analysed. Adherence data is pending. Intended outcome and impact Pilot telemedicine programs (e.g. TeleSleep) are developing services designed to provide accessible and efficient care to remote patients. $800 per patient, environmental and transport savings can be anticipated.