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Effects of telemedicine interventions in improving continuous positive airway pressure adherence in patients with obstructive sleep apnoea: a meta-analysis of randomised controlled trials

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Abstract

Purpose

This meta-analysis was conducted to assess the effects of telemedicine interventions on continuous positive airway pressure (CPAP) adherence in patients with obstructive sleep apnoea (OSA).

Methods

The PubMed, Cochrane Library, OVID, Web of Science and EBSCO host databases were searched from January 2004 to February 2020 for randomised controlled trials (RCTs) that assessed the effects of telemedicine interventions on CPAP adherence in patients with OSA. The study inclusion criteria were RCTs that compared patients who received telemedicine interventions with a control group and reported a change in CPAP adherence. The primary outcome was the improvement in CPAP adherence.

Results

In total, there were 11 RCTs (n = 1358) with quantitative analyses. Intervention times ranged from 1 to 6 months. Compared to controls, the telemedicine group exhibited better adherence to CPAP therapy (pooled mean difference (MD) = 0.57, 95% CI = 0.33 to 0.80, I2 = 7%, p < 0.00001). We performed sensitivity analyses by the type of telemedicine intervention, comorbidity burden, and OSA severity to explore whether or not their effect sizes may have affected the time of CPAP application. We performed subgroup analyses by follow-up duration, age, and OSA Epworth sleepiness scale (ESS) symptoms to determine if their effect sizes may have affected the time of CPAP application. However, these analyses did not change the statistical significance of the pooled estimate.

Conclusions

The use of telemedicine for up to 6 months may enhance CPAP adherence in patients with OSA, when compared to no intervention. Our study was searched from January 2004 to February 2020 for randomised controlled trials (RCTs) that assessed the effects of telemedicine interventions on CPAP adherence in patients with OSA. Future studies can continue to search for articles after February 2020

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Funding

This research was supported by Shanghai Municipal Commission of Science and Technology (Grant No.18DZ2260200) and Effects of telemedicine system interventions in improving continuous positive airway pressure adherence in patients with obstructive sleep apnoea: a systematic review (Grant No. X Within hospital-2320).

Author information

Author notes

  1. Yuli Hu, Yijia Su and Jun Ma contributed equally to this work.

Authors and Affiliations

  1. Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

    Yuli Hu, Sanlian Hu, Jun Ma, Zuoyan Zhang, Fang Fang & Jian Guan

  2. Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Yijia Su

  3. Department of Otolaryngology Head and Neck Surgery & Center of Sle-ep Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Yishan Road 600, Shanghai, 200233, China

    Yuli Hu, Fang Fang & Jian Guan

  4. Otolaryngological Institute of Shanghai Jiao Tong University, Yishan Road 600, Shanghai, 200233, China

    Yuli Hu, Fang Fang & Jian Guan

  5. Shanghai Key Laboratory of Sleep Disordered Breathing, Yishan Road 600, Shanghai, 200233, China

    Yuli Hu, Fang Fang & Jian Guan

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  1. Yuli Hu
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  2. Yijia Su
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  3. Sanlian Hu
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Correspondence to Sanlian Hu or Fang Fang.

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Hu, Y., Su, Y., Hu, S. et al. Effects of telemedicine interventions in improving continuous positive airway pressure adherence in patients with obstructive sleep apnoea: a meta-analysis of randomised controlled trials. Sleep Breath 25, 1761–1771 (2021). https://doi.org/10.1007/s11325-021-02292-5

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