Adherence to long-term non-invasive positive airway pressure therapy

Dan Med J. 2024 Oct 25;71(11):A04240290. doi: 10.61409/A04240290.

Abstract

Introduction: Studies have shown varying patient adherence to long-term non-invasive positive airway pressure therapy (nPAP). We aimed to investigate adherence to long-term nPAP in a Danish cohort of patients with chronic respiratory insufficiency and/or sleep-disordered breathing (SDB) due to neuromuscular disorders (NMD), obesity-hypoventilation syndrome (OHS) or other reasons.

Methods: This cohort study included all adult patients with association to the Respiratory Center East treated with long-term nPAP: bilevel (BiPAP), automatic (APAP) and continuous (CPAP) or adaptive servo-ventilation (ASV) with a remote monitoring system in April 2022. The primary outcome was adherence, defined as a median use of nPAP ≥ 4 hrs/day in April 2022. A preplanned extended subgroup analysis was conducted for patients with data on adherence from initiation and six months onwards.

Results: The primary analysis included 241 patients, of whom 90% were diagnosed with NMD (54%) or OHS (36%). The nPAP was used ≥ 4 hrs/day by 175 patients (73%), including 22 (100%) with ASV, 129 (72%) with BiPAP and 24 (59%) with APAP/CPAP. Treatment adherence was seen in 75% of patients with NMD, 64% with OHS and 84% with other reasons for SDB. The proportion of adherent subjects in the subgroup analysis of 55 patients was relatively stable throughout the six-month period, ranging from 67% to 75% with slight intraindividual variation.

Conclusion: In this retrospective analysis of adults primarily with NMD and OHS, 73% used the prescribed nPAP therapy ≥ 4 hrs/day.

Funding: None TRIAL REGISTRATION.

Clinicaltrials: gov(NCT05379309).

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Continuous Positive Airway Pressure
  • Denmark
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuromuscular Diseases / complications
  • Neuromuscular Diseases / therapy
  • Obesity Hypoventilation Syndrome* / therapy
  • Patient Compliance* / statistics & numerical data
  • Respiratory Insufficiency* / therapy
  • Retrospective Studies
  • Sleep Apnea Syndromes* / therapy

Associated data

  • ClinicalTrials.gov/NCT05379309