Effects of Mask Change/Renewal on Adherence to Positive Airway Pressure Therapy: Analysis of a Large Telemedicine Database.

Autor:	Schoebel C; University Duisburg-Essen, Department of Sleep Medicine, Essen, Germany., Woehrle H; Sleep and Ventilation Center Blauberuen/Lung Center Ulm, Ulm, Germany., Ficker JH; Paracelsus Medical University Nuernberg General Hospital, Department for Respiratory Medicine, Allergology and Sleep Medicine, Nuremberg, Germany., Graml A; ResMed Science Center, ResMed Germany, Martinsried, Germany., Zeman F; University Hospital Regensburg, Center for Clinical Studies, Regensburg, Bayern, Germany., Fietze I; Charité-Universitätsmedizin Berlin, Center of Sleep Medicine, Department of Cardiology and Pulmology, Berlin, Germany., Young P; Medical Park, Department of Neurology, Bad Feilnbach, Germany., Arzt M; University Hospital Regensburg, Department of Internal Medicine II, Regensburg, Germany; Michael.Arzt@klinik.uni-regensburg.de.
Jazyk:	angličtina
Zdroj:	Annals of the American Thoracic Society [Ann Am Thorac Soc] 2024 Sep 05. Date of Electronic Publication: 2024 Sep 05.
DOI:	10.1513/AnnalsATS.202310-913OC
Abstrakt:	Rationale: Adherence to positive airway pressure (PAP) therapy is a common and challenging issue. Although some studies have looked at the impact of initial mask selection, there is a lack of data regarding the impact of a change in mask on adherence to PAP therapy. Objective(s): This study investigated the impact of a mask change or renewal on mid-term PAP adherence. Methods: German homecare provider data were retrospectively analyzed. Patients aged ≥18 years who started PAP therapy in 2014-2019, had data on the type of device and interface (mask) used, and had mask change/renewal within ≤1 year after starting PAP were eligible. Mask change was defined as switching to a different mask type, while mask renewal referred to supply of a replacement mask of the same type. The primary endpoint was change in PAP usage after mask change/renewal, overall and in patient subgroups based on previous PAP usage (<4 and ≥4 h/night). Results: 12,551 patients were included (71% male; age 62±12 years); previous PAP usage was <4 h/night (n=3,510) or ≥4 h/night (n=9,041). After mask change/renewal, there was no change in device usage overall or in patients with previous usage ≥4 h/night. However, in those with PAP usage <4 h/night, mask change/renewal was associated with increased device usage (+55 min [+57 min for change, +39 min for renewal) and increased the proportion of days with PAP usage ≥4 h/night by 19% (+20% for change, +12% for renewal). In this patient subgroup, early mask change/renewal (within 90 days), higher levels of previous device usage and older age were significant predictors of improving device usage to ≥4 h/night after mask change/renewal. Conclusions: For patients with low PAP adherence on their existing mask system, early intervention to change or renew the mask was associated with clinically relevant improvements in device usage.
Databáze:	MEDLINE
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