Impact of telemedicine in long-term CPAP therapy: A twelve-month follow-up study in Japan utilizing propensity score matching.

BACKGROUND

Advances in digital technology have enabled the telemonitoring of CPAP therapy data, supporting the increasing use of telemedicine (TM) in CPAP management. During the COVID-19 pandemic, Japan's health insurance system allowed telephone consultations to reduce in-person visits as a temporary measure. This study examined whether the 12-month CPAP adherence differed between the TM and standard care groups.

METHODS

Patients undergoing CPAP therapy for at least 6 months for obstructive sleep apnea (OSA) were recruited from two Japanese clinics between May and July 2020. The TM group included patients who had not visited a clinic in person for 12 months but had received telephone consultations every 2 months. The standard-care group attended monthly in-person visits. Physicians in both groups reviewed CPAP data via telemonitoring. Adherence change was categorized as ≤-5 %, >-5 % to <5 %, or ≥5 %. The primary outcome was the proportion of patients with worsened adherence (≤-5 %).

RESULTS

Among 116 patients receiving TM and 171 receiving standard care, 45 from each group were matched using 1:1 propensity score nearest-neighbor matching; adherence improved in 8 (17.8 %) and 19 (42.2 %) patients, respectively. Changes in CPAP adherence over 12 months showed significant differences between the two groups, with the TM group exhibiting significantly fewer improvements than the standard care group (χ2 = 6.50, df = 2, P = 0.039).

CONCLUSION

CPAP adherence improved less in the TM group than in the standard care group over 12 months. Further research is required to optimize telemedicine strategies to enhance long-term adherence to CPAP therapy.

TRIAL REGISTRATION: The study was registered with the UMIN Clinical Trials Registry (UMIN000043177).