Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review
# Background Positive airway pressure (PAP) therapy is prescribed to patients with obstructive sleep apnea (OSA). A commonly used definition for PAP therapy adherence is based upon the minimum requirements to receive Medicare coverage in the US, defined as PAP usage of four or more hours per night...
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| Format: | Article |
| Language: | English |
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Canadian Society of Respiratory Therapists
2024-01-01
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| Series: | Canadian Journal of Respiratory Therapy |
| Online Access: | https://doi.org/10.29390/001c.92080 |
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| author | Daniel Stevens Michaela Title Kathleen Spurr Debra Morrison |
| author_facet | Daniel Stevens Michaela Title Kathleen Spurr Debra Morrison |
| author_sort | Daniel Stevens |
| collection | DOAJ |
| description | # Background
Positive airway pressure (PAP) therapy is prescribed to patients with obstructive sleep apnea (OSA). A commonly used definition for PAP therapy adherence is based upon the minimum requirements to receive Medicare coverage in the US, defined as PAP usage of four or more hours per night on 70 percent of nights for at least 30 consecutive days. However, little evidence exists to support this definition for PAP therapy adherence. Therefore, the present study sought to determine the efficacy of the present definition of PAP therapy adherence on longitudinal outcomes in patients with OSA, using objectively measured PAP device usage time.
# Methods
An exploratory longitudinal, retrospective, randomized chart review was done to assess clinical outcomes between patients with OSA who were defined as PAP therapy adherent (n=50) and non-adherent (n=50) during an eight-year observation period.
# Results
No significant differences were shown between groups for mortality, hospitalizations, or development of co-morbidities during the observation period. However, logistic regression showed significantly higher odds of adherence in male patients compared to female patients (OR=8.519; 95%CI=1.301--55.756; p=0.025) and significantly lower odds of adherence in patients with higher normal (OR=0.039; 95%CI=0.005--0.392; p=0.003), mild excessive (OR=0.039; 95%CI=0.003--0.517; p=0.014), and severe excessive (OR=0.088; 95%CI=0.012--0.635; p=0.016) daytime sleepiness compared to patients with lower normal daytime sleepiness. An increasing number of hospitalizations also corresponded with a significant decrease in odds of being adherent (OR=0.741; 95%CI=0.551--0.995; p=0.046).
# Conclusion
The present study supports a steadily growing body of literature calling for more consideration and evidence to support a definition of PAP therapy adherence that is clinically meaningful. |
| format | Article |
| id | doaj-art-a7ac954f80954f9887dea4a93fafd170 |
| institution | Kabale University |
| issn | 2368-6820 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Canadian Society of Respiratory Therapists |
| record_format | Article |
| series | Canadian Journal of Respiratory Therapy |
| spelling | doaj-art-a7ac954f80954f9887dea4a93fafd1702025-02-11T20:30:50ZengCanadian Society of Respiratory TherapistsCanadian Journal of Respiratory Therapy2368-68202024-01-0160Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart reviewDaniel StevensMichaela TitleKathleen SpurrDebra Morrison# Background Positive airway pressure (PAP) therapy is prescribed to patients with obstructive sleep apnea (OSA). A commonly used definition for PAP therapy adherence is based upon the minimum requirements to receive Medicare coverage in the US, defined as PAP usage of four or more hours per night on 70 percent of nights for at least 30 consecutive days. However, little evidence exists to support this definition for PAP therapy adherence. Therefore, the present study sought to determine the efficacy of the present definition of PAP therapy adherence on longitudinal outcomes in patients with OSA, using objectively measured PAP device usage time. # Methods An exploratory longitudinal, retrospective, randomized chart review was done to assess clinical outcomes between patients with OSA who were defined as PAP therapy adherent (n=50) and non-adherent (n=50) during an eight-year observation period. # Results No significant differences were shown between groups for mortality, hospitalizations, or development of co-morbidities during the observation period. However, logistic regression showed significantly higher odds of adherence in male patients compared to female patients (OR=8.519; 95%CI=1.301--55.756; p=0.025) and significantly lower odds of adherence in patients with higher normal (OR=0.039; 95%CI=0.005--0.392; p=0.003), mild excessive (OR=0.039; 95%CI=0.003--0.517; p=0.014), and severe excessive (OR=0.088; 95%CI=0.012--0.635; p=0.016) daytime sleepiness compared to patients with lower normal daytime sleepiness. An increasing number of hospitalizations also corresponded with a significant decrease in odds of being adherent (OR=0.741; 95%CI=0.551--0.995; p=0.046). # Conclusion The present study supports a steadily growing body of literature calling for more consideration and evidence to support a definition of PAP therapy adherence that is clinically meaningful.https://doi.org/10.29390/001c.92080 |
| spellingShingle | Daniel Stevens Michaela Title Kathleen Spurr Debra Morrison Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review Canadian Journal of Respiratory Therapy |
| title | Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review |
| title_full | Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review |
| title_fullStr | Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review |
| title_full_unstemmed | Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review |
| title_short | Positive airway pressure therapy adherence and outcomes in obstructive sleep apnea: An exploratory longitudinal retrospective randomized chart review |
| title_sort | positive airway pressure therapy adherence and outcomes in obstructive sleep apnea an exploratory longitudinal retrospective randomized chart review |
| url | https://doi.org/10.29390/001c.92080 |
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