Improving patient CPAP compliance
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Clinical Issue / Practice Problem: Continuous positive airway pressure (CPAP) improves symptoms and complications associated with obstructive sleep apnea (OSA); however, 40-70% of patients do not adhere to therapy. The purpose of this project was to increase the percentage of patients who meet national standards for CPAP adherence, defined as 70% usage.
Summary of Supporting Literature: Mobile health applications can improve treatment adherence in chronic conditions including OSA, diabetes, hypertension, and atrial fibrillation. A CPAP-specific mobile health application that provides daily CPAP usage scores, push notifications, and educational videos, has improved adherence when added to standard care.
Project Implementation: An individual education session on the application was provided to patients beginning CPAP therapy immediately following CPAP set-up. The education session included application download, account set-up, and instruction on use. The importance of CPAP adherence was also reinforced.
Outcomes: A comparison of adherence was conducted at therapy days 7 and 30 between the application educated patients and standard care patients. The percentage of application educated patients who met adherence was 75% at day 7 and 60% at day 30. For standard care patients 75% met adherence at day 7 and 55% at day 30.
Clinical Implications for Practice and Next Steps: A CPAP-specific mobile application is feasibly implemented into clinical practice and may promote CPAP adherence in patients with OSA. Incorporating a follow-up provider call may benefit future projects by reinforcing continued engagement with the application.