PT  - JOURNAL ARTICLE
AU  - Cheah Hooi Ken Lee
AU  - Leong Chai Leow
AU  - Pei Rong Song
AU  - Huihua Li
AU  - Thun How Ong
TI  - Adherence to continuous positive airway pressure therapy (CPAP) in patients with obstructive sleep apnea (OSA) in an Asian privately funded healthcare system
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P2264
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P2264.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P2264.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background and objective: We explored CPAP adherence patterns among OSA patients in a privately funded healthcare system.Methods: Patients who were newly diagnosed with symptomatic (Epworth sleepiness score (ESS) ≥10) moderate-severe OSA (apnea hypopnea index (AHI)>15) participated in a telephone interview 1 year after initiation of CPAP treatment to assess their level of adherence (using CPAP>4 hours/day). Logistic regression analysis was performed to evaluate for factors associated with CPAP adherence.Results: 135 out of 529 patients who underwent diagnostic polysomnography from January 2012 to June 2012 met inclusion criteria. 78 (57.8%) patients were initiated on CPAP treatment, but 57 (42.2%) patients rejected CPAP upfront. 41 (52.6%) patients who initiated CPAP were adherent at one year. Patients who were CPAP adherent had higher AHI (63.7 vs. 49.1, p=0.0011) and reported more symptomatic improvement after CPAP. Mask and machine related side effects were associated with lower adherence (p=0.015). Those who rejected CPAP therapy upfront cited inconvenience, cost and poor disease perception as reasons.Conclusions: In this Asian privately funded healthcare system, almost half of the patients with significant OSA rejected CPAP treatment upfront but adherence among those who started CPAP is comparable to other reports. A change in funding model and improved patient education may help improve CPAP uptake.