A new study reveals that shifting patients who are struggling with adherence to positive airway pressure (PAP) therapy to a more advanced bilevel device in the first 90 days of treatment is an effective tool for achieving adherence in well more than half of such cases.
This research, sponsored by ResMed, was presented at SLEEP 2018.
Patients diagnosed with sleep apnea are usually prescribed a PAP device that provides either continuous (CPAP) or auto-adjusting (APAP) pressure. A bilevel device delivers two distinct pressures, one for inhalation and one for exhalation. Physicians may prescribe bilevel for patients who are pressure intolerant or have continued evidence of apnea at higher pressures.
In this “bilevel rescue” study, ResMed compared 1,496 non-compliant patients (as defined by US Medicare guidelines) who switched to bilevel therapy and found that compliance was achieved by:
- 58.5% of patients who switched before day 60
- 54.2% of patients who switched between days 60–90
- 56.8% of patients overall
“Finding the right mode of therapy made all the difference to those patients who are struggling with initial adherence to therapy,” says ResMed chief medical officer Carlos M. Nunez, MD, in a release. “This strongly suggests that bilevel devices provide a powerful alternative therapy that physicians and HMEs [home medical equipment providers] can utilize to help improve non-compliant patients’ treatment experience and outcomes.”
Compliance with Positive Airway Pressure Therapy after Switching From CPAP to Bilevel for Non-Compliant OSA Patients: A Big Data Analysis queried a PAP device telemonitoring database for patients initiated on CPAP or APAP therapy between January 1, 2015, and July 31, 2016, who were not Medicare compliant and switched to bilevel PAP therapy within the first 90 days of therapy. Anonymous PAP therapy data on all patients were compared before and after the switch. The objectives of this study were to compare average daily usage, adherence, unintentional mask leak, and PAP efficacy (residual events) before and after switching to bilevel PAP therapy, as well as evaluating compliance using Medicare guidelines.