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T-Space at The University of Toronto Libraries >
Journal of Medical Internet Research >
Volume 9 (2007) >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/9827

Title: Pilot Randomized Trial of the Effect of Wireless Telemonitoring on Compliance and Treatment Efficacy in Obstructive Sleep Apnea
Authors: Stepnowsky, Carl J
Palau, Joe J
Marler, Matthew R
Gifford, Allen L
Keywords: Original Paper
Continuous positive airway pressure therapy
sleep apnea syndromes
treatment compliance
randomized controlled trial
Issue Date: 17-May-2007
Publisher: Gunther Eysenbach; Centre for Global eHealth Innovation, Toronto, Canada
Citation: Carl J Stepnowsky, Joe J Palau, Matthew R Marler, Allen L Gifford. Pilot Randomized Trial of the Effect of Wireless Telemonitoring on Compliance and Treatment Efficacy in Obstructive Sleep Apnea. J Med Internet Res 2007;9(2):e14 <URL: http://www.jmir.org/2007/2/e14/>
Abstract: [This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2007/2/e14/ ] Background: Obstructive sleep apnea (OSA) is a prevalent and serious medical condition characterized by repeated complete or partial obstructions of the upper airway during sleep and is prevalent in 2% to 4% of working middle-aged adults. Nasal continuous positive airway pressure (CPAP) is the gold-standard treatment for OSA. Because compliance rates with CPAP therapy are disappointingly low, effective interventions are needed to improve CPAP compliance among patients diagnosed with OSA. Objective: The aim was to determine whether wireless telemonitoring of CPAP compliance and efficacy data, compared to usual clinical care, results in higher CPAP compliance and improved OSA outcomes. Methods: 45 patients newly diagnosed with OSA were randomized to either telemonitored clinical care or usual clinical care and were followed for their first 2 months of treatment with CPAP therapy. CPAP therapists were not blinded to the participants’ treatment group. Results: 20 participants in each group received the designated intervention. Patients randomized to telemonitored clinical care used CPAP an average of 4.1 ± 1.8 hours per night, while the usual clinical care patients averaged 2.8 ± 2.2 hours per night (P = .07). Telemonitored patients used CPAP on 78% ± 22% of the possible nights, while usual care patients used CPAP on 60% ± 32% of the nights (P = .07). No statistically significant differences between the groups were found on measures of CPAP efficacy, including measures of mask leak and the Apnea-Hypopnea Index. Patients in the telemonitored group rated their likelihood to continue using CPAP significantly higher than the patients in the usual care group. Patients in both groups were highly satisfied with the care they received and rated themselves as “not concerned” that their CPAP data were being wirelessly monitored. Conclusions: Telemonitoring of CPAP compliance and efficacy data and rapid use of those data by the clinical sleep team to guide the collaborative (ie, patient and provider) management of CPAP treatment is as effective as usual care in improving compliance rates and outcomes in new CPAP users. This study was designed as a pilot—larger, well-powered studies are necessary to fully evaluate the clinical and economic efficacy of telemonitoring for this population.
Description: Reviewer: Smith, Carol
Reviewer: Aloia, Mark
URI: http://dx.doi.org/10.2196/jmir.9.2.e14
ISSN: 1438-8871
Rights: © Carl J Stepnowsky Jr, Joe J Palau, Matthew R Marler, Allen L Gifford. Originally published in the Journal of Medical Internet Research (http://www.jmir.org, 17.05.2007). Except where otherwise noted, articles published in the Journal of Medical Internet Research are distributed under the terms of the Creative Commons Attribution License (http://www.creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited, including full bibliographic details and the URL (see "please cite as" above), and this statement is included.
Appears in Collections:Volume 9 (2007)

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