Effect of Doctor and Device Manager on Adherence with Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients

Seon Lin Kim; Ji-a Kim; Deok-Soo Kim; Min-Gyu Jo; Sung-Dong Kim; Kyu-Sup Cho

doi:10.18787/jr.2018.25.1.26

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Kim, Kim, Kim, Jo, Kim, and Cho: Effect of Doctor and Device Manager on Adherence with Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients

Original Article

Journal of Rhinology 2018; 25(1): 26-31.

Published online: 31 May 2018

DOI: https://doi.org/10.18787/jr.2018.25.1.26

Effect of Doctor and Device Manager on Adherence with Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients

Seon Lin Kim, MD, Ji-a Kim, MD, Deok-Soo Kim, MD, Min-Gyu Jo, MD, Sung-Dong Kim, MD, Kyu-Sup Cho, MD

Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea.

Corresponding author (choks@pusan.ac.kr)

Received 10 September 2017 Revised 9 January 2018 Accepted 16 April 2018

Journal of Rhinology

Abstract

Background and Objectives

Although many studies have assessed factors related to adherence of PAP therapy, there were no studies about factors related to doctors or device managers. The purpose of this study was to investigate the relationship between PAP therapy adherence and doctor or device manager.

Subjects and Methods

Between February 2013 and June 2015, 163 patients newly diagnosed with moderate to severe OSA in one of five hospitals were enrolled in this study. All patients received 4 weeks of PAP treatment with intervention consisting of mechanical support and motivation by doctor and device manager. Data from the PAP device were obtained following a minimum of an initial 30 days, with adherence defined as >4 h/night on 70% of nights.

Results

After 30 days, total adherence rate to PAP therapy was 35.6% (n=58). The adherence rate of device manager ① was 26.3% (31/118), and that of device manager ② was 60% (27/45), and there was statistically significant difference between the two device managers. Furthermore, there were statistically significant differences in the adherence to PAP therapy ranging from 85.6% to 0.0% according to doctor.

Conclusion

Our study demonstrates that the device manager and doctor may be important factors for good adherence to PAP therapy in patients with OSA.

Keywords: Sleep apnea, obstructive, Continuous positive airway pressure, Patient compliance, Physicians, Device managers

Figures and Tables

Table 1

Demographic characteristics

Data are expressed as the number. Pts: patients, BMI: body mass index, AHI: apnea-hypopnea index

Table 2

Purchase rate according to device manager or doctors

Data are expressed as the patients'number (percentage). 1)

Chi-square test, 2) Fisher's exact test

Table 3

Adherence rate according to device manager or doctors

Data are expressed as the patients'number (percentage). 1)

Chi-square test, 2) Fisher's exact test

Table 4

Logistic regression analysis in device manager and doctors (1 month, purchase rate)

CI: confidence interval, NA: not applicable, OR: odds ratio, Ref: reference

Table 5

Logistic regression analysis in device manager and doctors (6 month, adherence rate)

CI: confidence interval, NA: not applicable, OR: odds ratio, Ref: reference

Acknowledgments

This work was supported by the year 2018 clinical research grant from Pusan National University Hospital.

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