Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

ORCID

https://orcid.org/0000-0002-4784-9752

Date of Award

Fall 2018

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

Department

School of Nursing

Advisor(s)

Maria G. DeValpine

Andrea Knopp

Evan Wenger

Abstract

Abstract

The aim of this project is to improve continuous positive airway pressure (CPAP) non-adherence in patients newly diagnosed with obstructive sleep apnea. Obstructive sleep apnea (OSA) is caused by recurrent collapse of the upper airway during sleep. Untreated, OSA is associated with co-morbidity and decreased quality of life. The standard for OSA treatment is CPAP. Adherence to CPAP is not optimal. Applying telemedicine technology to monitor adherence of CPAP treatment, allows for early intervention. Prior research has shown mixed results with use of telemedicine on non-adherence rates.

This is a pilot study using telemedicine to monitor adherence data to trigger patient support throughout the first 3 months of CPAP therapy. In total, 56 newly diagnosed OSA patients were randomized to standard care (SC, n=23) or telemedicine (TM, n=33). SC received follow-up appointment at 6-weeks; those in TM had weekly data monitoring for the first 3 months, in addition to standard care. If CPAP use did not meet adherence criteria, a support phone call was conducted. Study results were compared to baseline non-adherence rates.

Study results did not show significant improvement in CPAP non-adherence rates with telemedicine intervention compared to standard care (p=0.43). There was improvement in non-adherence rates in both TM (8.0%) and SC (15.8%) arms at 3-months, from baseline non-adherence rate (22.8%).

Although the improvement seen in CPAP non-adherence rates was not significant, future studies with larger sample sizes may note more robust significance. Clinical significance related to increased adherence rates should not be undervalued.

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