PT  - JOURNAL ARTICLE
AU  - J Pépin
AU  - R Tamisier
AU  - A Benjafield
AU  - P Rinder
AU  - F Lavergne
AU  - A Josseran
AU  - P Sinel-Boucher
AU  - P Cistulli
AU  - A Malhotra
AU  - P Hornus
AU  - S Bailly
TI  - Trajectories of CPAP termination and resumption: a French nationwide database analysis
AID  - 10.1183/13993003.congress-2022.4482
DP  - 2022 Sep 04
TA  - European Respiratory Journal
PG  - 4482
VI  - 60
IP  - suppl 66
4099  - http://erj.ersjournals.com/content/60/suppl_66/4482.short
4100  - http://erj.ersjournals.com/content/60/suppl_66/4482.full
SO  - Eur Respir J2022 Sep 04; 60
AB  - Rationale and aims: CPAP termination rates before 3 years as high as 50 % have been reported and are associated with a significantly higher risk of all-cause death. The objective of this study was to assess prevalence and determinants of CPAP resumption after a first CPAP termination and its impact on all-cause mortality.Method: Data from the French national health insurance reimbursement system were analysed for all new adult CPAP users starting treatment in 2015 and 2016. Patients were grouped according to their CPAP treatment behaviours regarding CPAP continuation, termination or resumption. Multivariable analyses including propensity score approaches were conducted.Results: From 344,969 patients included, 150,111 (43.5%) experienced a first CPAP termination in the 3 years following CPAP initiation. Among these, 27,212 (26%) were re-initiated on CPAP in the year following their first CPAP termination. At one year after resumption 65% were still continuing CPAP. Older age and a prescription for restarting CPAP given by a trained specialist (vs. a general practitioner) were associated with a lower risk of repeat CPAP termination after resumption. After propensity score matching, patients re-stopping their CPAP treatment after a first resumption had a higher one-year risk of all-cause mortality: HR: 1.61 [1.26-2.05], p<0.001.Conclusion: A quarter of OSA patients who stop CPAP restart treatment during the year following the interruption. There is a beneficial effect associated with reduced mortality compared to those who again terminate CPAP. These long-term trajectories of CPAP termination and resumption deserve further investigation to propose specific care pathways and improve outcomes.FootnotesCite this article as Eur Respir J 2022; 60: Suppl. 66, 4482.This article was presented at the 2022 ERS International Congress, in session “-”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).