Lee Jeonghyun, Jeong JunYeong, Lee Jaeha, Lee Jae Yong, Choi Ji Ho
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea.
J Rhinol. 2022 Nov;29(3):148-154. doi: 10.18787/jr.2022.00417. Epub 2022 Nov 30.
Little is known about studies evaluating positive airway pressure (PAP) compliance after re-prescription. Therefore, the aim of this study was to investigate PAP compliance after re-prescription in obstructive sleep apnea (OSA) patients who failed initial PAP therapy.
We retrospectively reviewed OSA patients who had received a re-prescription for PAP from March 2020 to June 2021. We compared the compliance rate between initial prescription and re-prescription for PAP and investigated the reasons for PAP failure after the first prescription.
A total of 10 consecutive OSA patients (mean age=45.6±13.7 years and male:female=8:2) who received a re-prescription for PAP were included. Of them, 8 patients (80%) met the compliance criteria (i.e., Korean National Health Insurance criteria) for PAP after re-prescription. The compliance rate increased from 36.3±18.2% (initial prescription) to 61.3±28.8% (re-prescription); this was not of statistical significance (p=0.074). PAP/mask-related discomfort was the most common reason for PAP failure, followed by nasal obstruction, unintentional mask removal, and pressure-related discomfort.
Even if initial PAP therapy fails, the proportion of patients who meet the compliance criteria may be improved through various forms of clinical aid and support after re-prescription of PAP.
关于重新开具正压通气(PAP)处方后评估其依从性的研究知之甚少。因此,本研究的目的是调查初次PAP治疗失败的阻塞性睡眠呼吸暂停(OSA)患者重新开具PAP处方后的依从性。
我们回顾性分析了2020年3月至2021年6月期间接受PAP重新处方的OSA患者。我们比较了PAP初次处方和重新处方后的依从率,并调查了首次处方后PAP治疗失败的原因。
共有10例连续接受PAP重新处方的OSA患者(平均年龄=45.6±13.7岁,男:女=8:2)纳入研究。其中,8例患者(80%)在重新开具PAP处方后达到了PAP的依从性标准(即韩国国家健康保险标准)。依从率从初次处方时的36.3±18.2%提高到重新处方时的61.3±28.8%;但差异无统计学意义(p=0.074)。PAP/面罩相关不适是PAP治疗失败最常见的原因,其次是鼻塞、无意中摘除面罩和压力相关不适。
即使初次PAP治疗失败,在重新开具PAP处方后,通过各种形式的临床辅助和支持,达到依从性标准的患者比例仍可能提高。