ADVERTISEMENT

Issue Navigator

Volume 15 No. 05
Earn CME
Accepted Papers





Review Articles

The Effect of Patient-Facing Applications on Positive Airway Pressure Therapy Adherence: A Systematic Review

Gaja F. Shaughnessy, MD1; Timothy I. Morgenthaler, MD1,2
1Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota; 2Division of Sleep Medicine, Mayo Clinic, Rochester, Minnesota

Study Objectives:

Many patients struggle with adherence to positive airway pressure (PAP) therapy for sleep apnea. In this systematic review we examined the effect that patient-facing applications (PFA)—web-based applications that interact directly with the patient—have on PAP adherence.

Methods:

A comprehensive search of PubMed, CINAHL, MEDLINE, and SCOPUS databases was performed. We looked for studies where: (1) patients were adults with sleep apnea initiating PAP therapy for the first time; (2) the intervention was a PFA that incorporated individual PAP use data; (3) the comparison was usual and/or telemedicine care, and (4) outcomes of objective PAP adherence data were recorded.

Results:

Seven studies were identified (two randomized trials, one prospective cohort trial, four retrospective cohort studies). Cumulatively the studies enrolled 304,328 patients, with individual enrollment ranging between 61 and 172,678 patients. Six studies showed that PFA use was associated with using PAP for significantly more hours per night (range 0.7–1.3 hours more). PFA cohorts used PAP a greater proportion of nights and had a lower rate of mask leak. There was no difference in apnea-hypopnea index and self-reported measures of symptoms between study groups.

Conclusions:

PFA use was associated with improved adherence to PAP therapy. Although this conclusion is based on only two small trials and predominantly observational studies and therefore should be tested in large prospective trials, the PAFs are inexpensive, do not draw on health care resources, and show promise in improving PAP therapy for OSA.

Citation:

Shaughnessy GF, Morgenthaler TI. The effect of patient-facing applications on positive airway pressure therapy adherence: a systematic review. J Clin Sleep Med. 2019;15(5):769–777.




Please login to continue reading the full article

Subscribers to JCSM get full access to current and past issues of the JCSM.

Login to JCSM

Not a subscriber?

Join the American Academy of Sleep Medicine and receive a subscription to JCSM with your membership

Subscribe to JCSM:  $75/volume year for individuals or $140/volume year for institutions to access all current articles and archives published in JCSM.

Download this article*:   $20 to access a PDF version of a specific article from the current issue of JCSM.

*Purchase of an electronic download of JCSM provides permission to access and print the issue/article for personal scholarly, research and educational use. Please note: access to the article is from the computer on which the article is purchased ONLY. Purchase of the article does not permit distribution, electronic or otherwise, of the article without the written permission of the AASM. Further, purchase does not permit the posting of article text on an online forum or website.