CPAP compliance with telemedicine at Medway Maritime Hospital: A retrospective, randomised pilot study

Background: CPAP adherence can be improved with the use of a web-based telemedicine system at the initiation of treatment. Objective: This study was designed to investigate if a telephone based intervention service would improve adherence to therapy. Methods: Patients with moderate to severe OSA were randomly selected and retrospectively reviewed. Patients given standard therapy in 2013 were compared to those who received telephone based intervention in 2014. The telephone based intervention included a telephone call on day 5. If problems were identified, an outpatient appointment was provided within 24 hours to assess and resolve any issues. Time to achieve compliance (defined as use of CPAP for >4 hrs on 5 consecutive nights), CPAP usage and AHI for each subgroup were analysed at 2 weeks, 1 month and 3 months. Results: Both groups had 50 patients. 70% of patients in both groups achieved compliance within 3 months. There was no significant difference in time to compliance, average CPAP usage per night and average CPAP adherence when used between the standard and intervention group as shown below. There was no significant difference between mean AHI in the standard and intervention groups (5.16 vs 5.17 respectively) at 3 months. Conclusion: We found no positive impact of a telephone service on CPAP compliance and adherence. This mode of telemedicine requires further investigation before routine use.