远程监测随访、副作用及其他因素对 CPAP 依从性的影响。

Effects of telemonitoring follow-up, side effects, and other factors on CPAP adherence.

机构信息

Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.

Centre for Clinical Research Sörmland (CKFD), Eskilstuna, Sweden.

出版信息

J Clin Sleep Med. 2023 Oct 1;19(10):1785-1795. doi: 10.5664/jcsm.10686.

DOI:10.5664/jcsm.10686

PMID:37323036

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10546003/

Abstract

STUDY OBJECTIVES

This study aimed to investigate the effect of telemonitoring compared with standard clinic visits on adherence to continuous positive airway pressure (CPAP) treatment after 6 months. In addition, the impact of other factors including CPAP side effects on treatment adherence were assessed.

METHODS

Consecutive patients (n = 217) who were prescribed CPAP treatment for obstructive sleep apnea were randomized to either telemonitoring or standard-care follow-up. All patients were followed up 6 months after treatment started. Clinical/anthropometric variables, socioeconomical and lifestyle factors, psychological distress, daily function, and personality traits along with CPAP side effects were assessed. Differences between groups were analyzed using 2-sample -test, chi-square test, or Fisher's exact test. Regression modeling was used to explore associations between dependent and independent variables.

RESULTS

There were no differences in CPAP adherence between telemonitoring and standard-care groups after 6 months (53.2% vs 48.7%; = .54). CPAP side effects such as dry throat (odds ratio = 2.17; 95% confidence interval = 1.25-3.70), increased awakenings (2.50; 1.31-4.76), and exhaling problems (3.70; 1.25-10.1) were independently associated with low CPAP adherence, although these associations were weakened when adding smoking to the model. No other baseline or follow-up factors were associated with CPAP adherence at 6 months.

CONCLUSIONS

We could not show that telemonitoring follow-up improved adherence levels. Dry throat, increased awakenings, exhaling problems, and smoking had negative effects on CPAP adherence. Preventing side effects and assessing smoking status is therefore of importance when wanting to improve CPAP adherence.

CLINICAL TRIAL REGISTRATION

Registry: ClinicalTrials.gov; Name: Benefits of Telemedicine in CPAP Treatment; URL: https://clinicaltrials.gov/ct2/show/NCT03202602; Identifier: NCT03202602.

CITATION

Delijaj F, Lindberg E, Johnsson L, Kristiansson P, Tegelmo T, Theorell-Haglöw J. Effects of telemonitoring follow-up, side effects, and other factors on CPAP adherence. . 2023;19(10):1785-1795.

摘要

研究目的

本研究旨在探讨与标准门诊就诊相比，远程监测对 CPAP 治疗 6 个月后依从性的影响。此外，还评估了 CPAP 副作用等其他因素对治疗依从性的影响。

方法

连续 217 例因阻塞性睡眠呼吸暂停而接受 CPAP 治疗的患者被随机分配至远程监测组或标准护理随访组。所有患者在治疗开始后 6 个月进行随访。评估临床/人体测量学变量、社会经济和生活方式因素、心理困扰、日常功能和人格特征以及 CPAP 副作用。使用 2 样本 t 检验、卡方检验或 Fisher 确切检验分析组间差异。回归模型用于探索因变量和自变量之间的关联。

结果

在治疗 6 个月后，远程监测组和标准护理组的 CPAP 依从性无差异（53.2%与 48.7%；=.54）。CPAP 副作用如口干（比值比=2.17；95%置信区间=1.25-3.70）、觉醒增加（2.50；1.31-4.76）和呼气问题（3.70；1.25-10.1）与 CPAP 依从性低独立相关，但当将吸烟纳入模型时，这些关联减弱。其他基线或随访因素与治疗 6 个月后的 CPAP 依从性无关。

结论

我们未能证明远程监测随访可提高依从水平。口干、觉醒增加、呼气问题和吸烟对 CPAP 依从性有负面影响。因此，在提高 CPAP 依从性时，预防副作用和评估吸烟状况很重要。

临床试验注册

注册号：ClinicalTrials.gov；名称：远程医疗在 CPAP 治疗中的获益；网址：https://clinicaltrials.gov/ct2/show/NCT03202602；标识符：NCT03202602。

参考文献

Delijaj F, Lindberg E, Johnsson L, Kristiansson P, Tegelmo T, Theorell-Haglöw J. Effects of telemonitoring follow-up, side effects, and other factors on CPAP adherence.. 2023;19(10):1785-1795.