Accessibility and adherence to positive airway pressure treatment in patients with obstructive sleep apnea: a multicenter study in Latin America
| Autor: | Dalva Poyares, Guido Simonelli, Ligia Mendonça Lucchesi, Sebastián Leiva, Guadalupe Terán, Leonardo Serra, Sergio Tufik, Maria Angélica Bazurto, Juan Facundo Nogueira, José Luis Carrillo-Alduenda, Daniel Pérez-Chada, V. Santiago-Ayala, Lia Bittencourt, Jorge Rey de Castro, Matilde Valencia-Flores, María Eugenia Franchi |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Latin Americans purl.org/pe-repo/ocde/ford#3.02.25 [https] medicine.medical_treatment Continuous positive airway pressure Health Services Accessibility Internal medicine Surveys and Questionnaires Positive airway pressure Medicine Humans In patient Aged Sleep Apnea Obstructive Continuous Positive Airway Pressure business.industry Anthropometry Middle Aged medicine.disease Obstructive sleep apnea respiratory tract diseases Cross-Sectional Studies Latin America Otorhinolaryngology purl.org/pe-repo/ocde/ford#3.02.07 [https] Compliance to treatment Patient Compliance Female Neurology (clinical) business Body mass index |
| Zdroj: | Sleepbreathing = SchlafAtmung. 24(2) |
| ISSN: | 1522-1709 |
| Popis: | Purpose: Information on access and adherence to positive airway pressure (PAP) treatment is lacking at the regional level in Latin America. This study characterized access and adherence to PAP in patients with moderate-severe obstructive sleep apnea (OSA) in Latin America. Methods: Cross-sectional study, conducted at 9 sleep centers across Argentina, Brazil, Chile, Colombia, Mexico, and Peru. Adults diagnosed with moderate-severe OSA (apnea-hypopnea index [AHI] ≥ 15/h) in the previous 12–18 months were eligible. Anthropometrics, health coverage, and OSA severity data were collected. Data on access to therapy, barriers to access, adherence, and factors related to non-compliance were obtained via standardized telephone survey. Results: Eight hundred eighty patients (70% male, 54 ± 13 years, AHI 49 ± 28/h, body mass index 32 ± 7 kg/m2) were included. Four hundred ninety patients (56%) initiated PAP, 70 (14%) discontinued therapy during the first year (mainly due to intolerance), and 420 (48%) were still using PAP when surveyed. Health insurance was private in 36.9% of patients, via the social security system in 31.1%, and via the state in 13.3%, and 18.7% did not have any coverage; 49.5% of patients had to pay all equipment costs. Reasons for not starting PAP were unclear or absent indication (42%), coverage problems (36%), and lack of awareness of OSA burden (14%). Patients with better adherence were older (55.3 ± 13 vs 52 ± 13; p = 0.002) and had more severe OSA (AHI 51.8 ± 27 vs 45.6 ± 27; p = 0.001). Conclusions: Less than half moderate-severe OSA patients started and continue to use PAP. Unclear or absent medical indication and financial limitations were the most relevant factors limiting access to therapy. |
| Databáze: | OpenAIRE |
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