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A7450 - Telemedicine System for Optimizing CPAP Adherence in Japan: Multicenter Randomized Trial
Author Block: K. Chin1, K. Murase1, K. Tanizawa2, N. Takahashi3, T. Tsuda4, M. Ohi5, T. Akahoshi6, K. Narui7, H. Nakamura8, T. Ohdaira9, H. Yoshimine10, T. Tsuboi11, Y. Yamashiro12, S. Ando13, T. Kasai14, H. Kita15, K. Tatsumi16, N. Burioka17, K. Tomii18, Y. Kondo19, T. Oga1, T. Nakayama3, T. Sakamaki20, T. Kuroda21, T. Hirai2; 1Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan, 2Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan, 3Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan, 4Kirigaoka Tsuda Hospital, Fukuoka, Japan, 5Osaka Kaisei Hospital, Osaka, Japan, 6Shinjuku Sleep and Respiratory Clinic, Tokyo, Japan, 7Toranomon Hospital, Tokyo, Japan, 8Nakamura Clinic, Okinawa, Japan, 9National Nishi-Niigata Central Hospital, Niigata, Japan, 10Inoue Hospital, Nagasaki, Japan, 11Respiratory Medicine, National Hospital Organization Minami Kyoto Hospital, Kyoto, Japan, 12Uresinogaoka Samaritan Hospital, Okinawa, Japan, 13Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan, 14Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan, 15Respiratory Medicine, Takatsuki Red Cross Hospital, Osaka, Japan, 16Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan, 17Department of Pathobiological Science and Technology, Tottori University Faculty of Medicine, School of Science, Tottori, Japan, 18Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan, 19Tosei General Hospital, Aichi, Japan, 20System Integration Center, Gunma University Hospital, Gunma, Japan, 21Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Rationale: In the clinical practice of treatment of obstructive sleep apnea (OSA), maintaining patients’ adherence to continuous positive airway pressure (CPAP) therapy is of significance. In Japan, under the public health insurance system, OSA patients are required to visit a clinic every three months, at least. In fact, 80% of patients come to the clinic every month. Despite this, optimizing adherence to CPAP is still challenging. Telemonitoring of the use of CPAP devices could be useful to optimize adherence. Methods: This multicenter 3-arm randomized trial was performed in 17 Japanese sleep centers and clinics. Inclusion criteria for participation were: 1) diagnosis of OSA by an overnight sleep study, 2) started CPAP more than three months previously; and 3) visited the sleep center or clinic every one or two months. Participants were randomly allocated to three groups: Group 1, clinic visits every three months and telemonitoring of CPAP adherence; Group 2, clinic visits every three months; and Group 3, clinic visits every month. In Group 1, CPAP adherence was monitored monthly with a telemonitoring system, and each physician in charge contacted the patient by phone to provide advice to optimize adherence. In Groups 2 and 3, adherence was checked at every clinic visit. Data on adherence to CPAP were analyzed for 6 months. Results: 491 patients (men: n=424, 60±13 years old) were randomized to three groups. As of October 31, 172 patients had completed the protocol. The final day of the observational period in this study will be the end of February, 2018. We will be able to report the up-to-date data analysis in May 2018.
Conclusion: The effect of telemedicine system on CPAP treatment for OSA patients in Japan will be evaluated by the present study.