Isetta Valentina, León Carmen, Torres Marta, Embid Cristina, Roca Josep, Navajas Daniel, Farré Ramon, Montserrat Josep M
Unit of Biophysics and Bioengineering, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
Interact J Med Res. 2014 Feb 19;3(1):e6. doi: 10.2196/ijmr.3060.
Telemedicine seems to offer reliable solutions to health care challenges, but significant contradictory results were recently found. Therefore, it is crucial to carefully select outcomes and target patients who may take advantage of this technology. Continuous positive airway pressure (CPAP) therapy compliance is essential to treat patients with obstructive sleep apnea (OSA). We believe that OSA patients could benefit greatly from a telemedicine approach for CPAP therapy management.
The objective of our study was to evaluate the application of a telemedicine-based approach in the CPAP therapy management, focusing on patients' CPAP follow-up and training.
We performed two studies. First, (study 1) we enrolled 50 consecutive OSA patients who came to our sleep center for the CPAP follow-up visit. Patients performed a teleconsultation with a physician, and once finalized, they were asked to answer anonymously to a questionnaire regarding their opinion about the teleconsultation. In a second randomized controlled trial (RCT) (study 2), we included 40 OSA patients scheduled for CPAP training. There were 20 that received the usual face-to-face training and 20 that received the training via videoconference. After the session, they were blindly evaluated on what they learned about OSA and mask placement.
More than 95% (49/50) of the interviewed patients were satisfied with the teleconsultation, and 66% (33/50) of them answered that the teleconsultation could replace 50%-100% of their CPAP follow-up visits. Regarding the RCT, patients who received the CPAP training via videoconference demonstrated the same knowledge about OSA and CPAP therapy as the face-to-face group (mean 93.6% of correct answers vs mean 92.1%; P=.935). Performance on practical skills (mask and headgear placement, leaks avoidance) was also similar between the two groups.
OSA patients gave a positive feedback about the use of teleconsultation for CPAP follow-up, and the CPAP training based on a telemedicine approach proved to be as effective as face-to-face training. These results support the use of this telemedicine-based approach as a valuable strategy for patients' CPAP training and clinical follow-up.
远程医疗似乎为医疗保健挑战提供了可靠的解决方案，但最近发现了显著的矛盾结果。因此，仔细选择可能受益于这项技术的结果指标和目标患者至关重要。持续气道正压通气（CPAP）治疗的依从性对于治疗阻塞性睡眠呼吸暂停（OSA）患者至关重要。我们认为，OSA患者可以从远程医疗方法进行CPAP治疗管理中大大受益。
我们研究的目的是评估基于远程医疗的方法在CPAP治疗管理中的应用，重点关注患者的CPAP随访和培训。
我们进行了两项研究。首先，（研究1）我们招募了50名连续到我们睡眠中心进行CPAP随访的OSA患者。患者与医生进行了远程会诊，一旦完成，他们被要求匿名回答一份关于他们对远程会诊看法的问卷。在第二项随机对照试验（RCT）（研究2）中，我们纳入了40名计划接受CPAP培训的OSA患者。其中20名接受了常规面对面培训，20名通过视频会议接受了培训。培训结束后，对他们关于OSA和面罩佩戴的所学内容进行了盲法评估。
超过95%（49/50）的受访患者对远程会诊感到满意，其中66%（33/50）的患者回答远程会诊可以取代他们50%-100%的CPAP随访就诊。关于RCT，通过视频会议接受CPAP培训的患者对OSA和CPAP治疗的了解与面对面培训组相同（正确答案的平均比例分别为93.6%和92.1%；P=0.935）。两组在实践技能（面罩和头带佩戴、避免漏气）方面的表现也相似。
OSA患者对使用远程会诊进行CPAP随访给予了积极反馈，基于远程医疗方法的CPAP培训被证明与面对面培训一样有效。这些结果支持将这种基于远程医疗方法作为患者CPAP培训和临床随访的有价值策略。
