Telemedicine home CPAP titration and follow-up in the COVID-19 scenario. Issue 4 (24th October 2022)

• Record Type: Journal Article
• Authors: Bordas-Martinez, Jaume; Salord, Neus; Fontanilles, Eva; Prado, Eliseo; Calvo, María; Carmezim, João; Santos, Salud; Monasterio, Carmen
• Is Part Of: ERJ open research. Volume 8:Issue 4(2022)
• Publication Date: 2022-10-24
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; Respiration; Respiratory organs -- Diseases; Respiratory organs -- Diseases -- Treatment; Respiratory Tract Diseases; Electronic journals; Fulltext; Internet Resources; Periodicals; Periodical; 616.2005
• DOI: 10.1183/23120541.00084-2022
• Languages: English
• ISSNs: 2312-0541

Abstract

Introduction: Continuous positive airway pressure (CPAP) titration was dramatically affected by the coronavirus disease 2019 (COVID-19) pandemic due to increased biological risk. This study aimed to compare successful CPAP adaptation and compliance with home telemedicine CPAP titration with the usual method based on face-to-face visits. Methodology: A prospective cohort using telemedicine home CPAP titration and follow-up during the COVID-19 pandemic (TC) was compared with a retrospective cohort receiving face-to-face pre-pandemic home titration (RC). The TC included a subgroup with a smartphone application (TC-APP). Successful CPAP adaptation and compliance at 1 month of follow-up were the main endpoints, while patient satisfaction and costs were secondary endpoints. Results: 210 consecutive patients were evaluated (80 RC and 130 TC). 36 patients were in the TC-APP subgroup. CPAP titration was successful in 90% in RC versus 95% in TC and 100% in TC-APP. No compliance differences between groups were found at 1 month (4.79 h·night −1 RC, 4.33 h·night −1 TC and 4.59 h·night −1 TC-APP). Mean±sd patient satisfaction out of 10 was 7.69±2.05 in RC versus 9.02±0.64 in TC (p<0.001). 64% of the TC-APP subgroup reported that their telemedicine strategy influenced an increase in CPAP use (p=0.011). CPAP adaptation with follow-up had an estimated direct staff cost per patient of EUR 19.61±8.61 in TC with no smartphone application used versus EUR 23.79±9.94 in TC-APP (p=0.048). Conclusions: Telemedicine in CPAP titration and early follow-up is equivalent to the usual care in terms of successful adaptation and compliance, while achieving greater patient satisfaction. Telemedicine home CPAP titration and early follow-up is equivalent to usual care in adaptation and compliance while achieving greater patient satisfaction. The use of the mHealth application may help patients self-empower and encourage increased CPAP use. https://bit.ly/3xwvwLX