Brief Report
Early Telemedicine to Promote Continuous Positive Airway Pressure Adherence

https://doi.org/10.1016/j.nurpra.2018.10.007Get rights and content

Highlights

  • Seventy-one percent of telemedicine patients were adherent to CPAP at follow-up.

  • CPAP adherence was greater in patients who received telemedicine versus comparison.

  • Telemedicine may promote adherence to CPAP therapy in patients with obstructive sleep apnea.

Abstract

Obstructive sleep apnea can have consequences such as cardiovascular disease and motor vehicle accidents. Continuous positive airway pressure (CPAP) is the gold standard treatment, but nonadherence limits efficacy. This project used a telemedicine strategy that included remote adherence monitoring and telephone communication from a nurse practitioner in the first week of CPAP therapy to promote adherence. Of patients who received the telemedicine, 71% were adherent at follow-up. Incorporating telemedicine into clinical practice may promote adherence to CPAP therapy.

Section snippets

Methods

The project was approved by the University of Illinois at Chicago Institutional Review Board and an authorization agreement was completed with Saint Louis University. Patients were eligible to participate if they were aged 18 or older, had been diagnosed with OSA, and were using CPAP therapy for the first time or resuming CPAP therapy after a period of nonuse. Patients were excluded if they did not speak English or did not have access to a telephone.

All patients who were seen in the nurse

Results

Thirty patients were identified for this project between May and October 2017. Six patients did not attend their scheduled sleep studies, 6 were not diagnosed with OSA, 3 received a CPAP device that did not connect to the online program, and 1 patient had a disconnected telephone number. As a result, these 16 patients were excluded, and 14 patients were included in the telemedicine group. Fourteen patients were also identified for the comparison group. The 2 groups were demographically similar,

Discussion

This project was an initial evaluation of a telemedicine strategy implemented in the first week of CPAP therapy in a small group of patients being treated for OSA. Patients who received the telemedicine strategy were more adherent to CPAP than patients who did not, which is consistent with prior work in this area.15, 16, 17 This project used a provider-driven approach that included person-to-person telephone calls from the nurse practitioner. Other work in this area used a research nurse,15

Conclusion

OSA is a common chronic disease associated with significant morbidity and health care resource utilization. The negative consequences of OSA can only be reduced with effective treatment; thus, a strong focus on CPAP adherence is necessary. This project was a nurse practitioner–led initiative to promote CPAP adherence that resulted in 71% of patients achieving acceptable adherence based on national standards. Although an entirely nurse practitioner–led initiative would not be sustainable

Melissa Carlucci, DNP, ACNP-BC is a clinical assistant professor at the University of Illinois at Chicago College of Nursing, Chicago, IL. She can be reached at [email protected].

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Cited by (1)

Melissa Carlucci, DNP, ACNP-BC is a clinical assistant professor at the University of Illinois at Chicago College of Nursing, Chicago, IL. She can be reached at [email protected].

Joanne Thanavaro, DNP, AGPCNP-BC, AGACNP-BC, FAANP is an associate professor of nursing, Saint Louis University, Saint Louis, MO.

In compliance with national ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.

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