Kumar Shefali, Rudie Emma, Dorsey Cynthia, Caswell Kimberly, Blase Amy, Sert Kuniyoshi Fatima, Benjafield Adam V, Sullivan Shannon S
Verily Life Sciences, South San Francisco, CA, United States.
ResMed Science Center, San Diego, CA, United States.
Front Digit Health. 2023 Jun 7;5:1043578. doi: 10.3389/fdgth.2023.1043578. eCollection 2023.
This single-arm, decentralized pilot study assessed patient journey, positive airway pressure (PAP) usage and program satisfaction for users of an entirely virtual telemedicine program for obstructive sleep apnea (OSA) diagnosis and management. This analysis focuses specifically on the subset of participants in the program who were diagnosed with OSA and prescribed PAP therapy.
The Verily Clinical Studies Platform was used for virtual screening, consent, and enrolling eligible patients from North Carolina and Texas. After completing the virtual OSA diagnosis process, participants diagnosed with OSA and prescribed PAP therapy downloaded the program's mobile app. The app featured tools such as educational content, live coaching support, and motivational enhancement.
Of the patients included in this analysis ( = 105), the majority were female (58%), and white (90%). The mean time from first televisit to PAP initiation was 29.2 (SD 12.8) days and f 68 out of the 105 patients (65%) reached 90-day adherence. On average, patients used their PAP device for 4.4 h per day, and 5.4 h on days used. Engagement with the app was associated with higher rates of PAP adherence. Adherent individuals used the mobile app 52 out of the 90 days on average, compared to non-adherent individuals who used the app on 35 out of the 90 days on average ( = 0.0003).
All of the 105 patients in this program diagnosed with OSA and prescribed PAP therapy were able to efficiently complete the entire OSA diagnostic pathway. The majority of these individuals also were able to adhere to their prescribed PAP therapy and had clinically meaningful PAP usage rates over the 90 days of therapy. Future studies might further evaluate the impact of this type of end-to-end virtual program on longer-term adherence and clinical outcomes over time.
https://clinicaltrials.gov/ct2/show/NCT04599803?term=NCT04599803&draw=2&rank=1, identifier NCT04599803.
本单臂、分散式试点研究评估了完全虚拟远程医疗项目的用户在阻塞性睡眠呼吸暂停（OSA）诊断和管理方面的就医过程、持续气道正压通气（PAP）使用情况及项目满意度。本分析特别关注该项目中被诊断为OSA并开具PAP治疗处方的参与者子集。
使用Verily临床研究平台进行虚拟筛查、获取知情同意并招募来自北卡罗来纳州和得克萨斯州的符合条件的患者。在完成虚拟OSA诊断过程后，被诊断为OSA并开具PAP治疗处方的参与者下载了该项目的移动应用程序。该应用程序具有教育内容、实时辅导支持和激励增强等工具。
在纳入本分析的患者中（n = 105），大多数为女性（58%），且为白人（90%）。从首次远程就诊到开始使用PAP的平均时间为29.2（标准差12.8）天，105名患者中有68名（65%）达到了90天的依从性。患者平均每天使用PAP设备4.4小时，使用日平均使用5.4小时。使用该应用程序与更高的PAP依从率相关。依从者在90天中平均有52天使用移动应用程序，相比之下，不依从者在90天中平均有35天使用该应用程序（P = 0.0003）。
该项目中所有105名被诊断为OSA并开具PAP治疗处方的患者都能够高效完成整个OSA诊断流程。这些个体中的大多数也能够坚持其规定的PAP治疗，并且在90天的治疗期间有具有临床意义的PAP使用率。未来的研究可能会进一步评估这种端到端虚拟项目对长期依从性和随着时间推移的临床结局的影响。
https://clinicaltrials.gov/ct2/show/NCT04599803?term=NCT04599803&draw=2&rank=1，标识符NCT04599803。
