Abstract
There are currently few data on the impact of mask resupply on longer-term adherence to positive airway pressure (PAP) therapy. This retrospective analysis investigated the effects of mask/mask cushion resupply on the adherence to PAP versus no resupply. Deidentified patient billing data for PAP supply items were merged with telemonitoring data from Cloud-connected AirSense 10/AirCurve 10 devices via AirViewTM (ResMed). Eligible patients started PAP between 1 July 2014 and 17 June 2016, had ≥360 days of PAP device data, and achieved initial U.S. Medicare adherence criteria. Patients who received a resupply of mask systems/cushions (resupply group) were propensity-score-matched with those not receiving any mask/cushion resupply (control group). A total of 100,370 patients were included. From days 91 to 360, the mean device usage was 5.6 and 4.5 h/night in the resupply and control groups, respectively (p < 0.0001). The proportion of patients with a mean device usage ≥4 h/night was significantly higher in the resupply group versus the control group (77% vs. 59%; p < 0.0001). The therapy termination rate was significantly lower in the resupply group versus the control group (14.7% vs. 31.9%; p < 0.0001); there was a trend toward lower therapy termination rates as the number of resupplies increased. The replacement of mask interface components was associated with better longer-term adherence to PAP therapy versus no resupply.
Highlights
Obstructive sleep apnea (OSA) is a common disorder with major neurocognitive and cardiometabolic sequelae [1]
The mean apnea–hypopnea index (AHI) and median 95th percentile leak were slightly but statistically significantly lower in the resupply group compared with the control group (Table 2)
This study showed that regular mask resupply was associated with better usage of the positive airway pressure (PAP) therapy from 3 months to 1 year after treatment initiation
Summary
Obstructive sleep apnea (OSA) is a common disorder with major neurocognitive and cardiometabolic sequelae [1]. Recent estimates suggest that the number of people worldwide with OSA is up to 1 billion [2]. This finding highlights the importance of raising awareness of OSA and emphasizes the need for efficient approaches to large-scale diagnosis and treatment. We have recently reported that the utilization of new technology might contribute to improved device usage and a higher proportion of patients meeting the U.S Center for Medicare and Medicaid Services (CMS, Woodlawn, MD, USA) PAP adherence criteria [13]. The use of new technology, such as the patient engagement tool in the study described above, is a novel and compelling approach for improving adherence. The aim was to test the hypothesis that mask resupply would be associated with improved adherence to PAP therapy versus no resupply
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