The Effect of Telemonitoring (TM) on Improving Adherence with Continuous Positive Airway Pressure (CPAP) in Obstructive Sleep Apnoea (OSA): A Service Improvement Project (SIP)

The benefits of CPAP demonstrated in clinical trials are difficult to deliver in real life due to the lack of adherence. We analysed the effect of a Telemonitoring (TM)-related intervention on adherence as part of a Service Improvement Project (SIP) analysed as a retrospective cohort study. The 'historical control' (HC) cohort (followed up in conventional clinics) included all patients who commenced on CPAP between 1 February and 30 April 2019 (n = 142). The 'telemonitoring' (TM) cohort included all patients who commenced on CPAP between 1 May and 31 July 2019 (n = 166). Adherence was checked at 30 days (baseline) and 73 days for both cohorts. Wilcoxon-Rank test was used for statistical analysis (results reported as mean +/- SEM). Both cohorts had similar adherence at the 30-day baseline, compared to a significantly lower adherence in the HC-cohort at 73 days (55.7 +/- 3.0 vs. 51.8 +/- 3.2% of days >= 4 h: p = 0.0072, average usage 255 +/- 12.8 vs. 236 +/- 13.7 min: p = 0.0003). There was a significantly higher adherence in the TM-cohort at 73 days (50.8 +/- 2.5 vs. 56.1 +/- 2.9% of days >= 4 h: p = 0.0075; average usage 234 +/- 10.4 vs. 252 +/- 12.1 min: p = 0.0456). Telemonitoring-feedback is effective at improving adherence with CPAP, suggesting its potential beneficial role in the community setting, particularly in the post-COVID reality of increased remote consultations.