Telemonitoring, coaching program increased short-term CPAP use

A 3-month telemonitoring and coaching program resulted in immediate short-term improvements in CPAP adherence, but failed to lead to sustained improvements over time, researchers reported.

“Several studies have demonstrated benefits of sustained behavioral interventions based around the concepts of motivational interviewing delivered for longer than 3 months over no such intervention,” Sanjay R. Patel, MD, MS, professor of medicine, epidemiology, and clinical and translational sciences and director of the Center for Sleep and Cardiovascular Outcomes Research at the University of Pittsburgh Medical Center, and colleagues wrote in Annals of the American Thoracic Society. “However, evidence for the superiority of a sustained behavioral intervention over a time-limited one on CPAP adherence is limited.”

Researchers assessed real-world CPAP adherence data from 26,489 patients who initiated CPAP from July 2018 to March 2020 (mean age, 55 years; 36% women). All participants utilized a 12-month commercially available telemonitoring and coaching program (Philips Respironics). The researchers compared those received 12 months (n = 3,264) or 3 months (n = 15,424) of support with those initiated CPAP without any support (n = 7,801).

Overall nightly CPAP use declined from 4.9 hours at 1 month to 4.5 hours at 3 months, 4 hours at 6 months, 3.6 hours at 12 months and 3.2 hours at 18 months.

Mean CPAP use differed slightly in the first month, at 5 hours of use for patients who received 12 months of support, 4.9 hours for patients who received 3 months of CPAP and 4.8 hours for patients who did not receive support.

Patients who received 3 months of support had greater CPAP use compared with patients who received no support (4.6 vs. 4.3 hours; P < .001). However, by 12 and 18 months, CPAP use declined to match that of patients who received no support. Patients who received 12 months of support had greater CPAP use compared with those who received no support at 3 months (4.6 vs. 4.3 hours; P < .001), 12 (4 vs. 3.6 hours; P < .001) and 18 months (3.3 vs. 3.2 hours; P = .02).

“Future research is needed to identify the optimal duration of behavioral interventions to sustain CPAP use long-term, and randomized trials in this area are needed,” the researchers wrote.