Effectiveness of mailed versus in-person PAP initiation in VA's TeleSleep program.

IF 3.5 3区医学 Q1 CLINICAL NEUROLOGY

Journal of Clinical Sleep Medicine Pub Date : 2025-04-02 DOI:10.5664/jcsm.11692

Alexander Gomez, Kathleen F Sarmiento, Connor Smith, Michael Mitchell, Diane Lee, Annette Totten, Elizabeth Sanders, Armand M Ryden, Jiyeon Seo, Sarathi Bhattacharyya, Brian Harris, Roberto Mempin, Isabel Moghtaderi, Yameena Jawed, Nikita Jambulingam, Jennifer Martin, Michelle Zeidler

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引用次数: 0

Abstract

Study objectives: This study sought to evaluate whether telehealth set-up was non-inferior to in-person set-up for veterans initiating PAP therapy.

Methods: PAP setups before and after the COVID-19 pandemic were identified at two VA health systems. Telehealth PAP set-ups occurred between March, 2020 and December 2021. The in-person PAP set ups occurred between January and December, 2019. PAP data was extracted for days 1-30 (month 1) and 60-90 (month 3). PAP use was compared between in-person and tele-medicine utilizing hours used per night, days used (out of 30 days), and residual AHI (among compliant users). Non-inferiority analyses were performed, using the following non-inferiority margins: 45 minutes for hours used, 4 days for days of usage, and 5 events per hour for residual AHI.

Results: 432 VA patients (93.5% male) who underwent PAP set up were included (224 in person; 208 telehealth). Non-inferiority was established for PAP usage at month 1 (90% CI=-0.31,0.53) and month 3 (90% CI=-0.18, 0.71), days used at month 1 (90% CI=-2.28, 1.33) and month 3 (90% CI=-1.75, 2.20), and residual AHI at month 1 (90% CI=-0.40, 1.62) and month 3 (90% CI=-0.69, 2.30).

Conclusions: Initiation of PAP therapy via telehealth was non-inferior to in-person set up visits in terms of PAP adherence among Veterans who use VA care.

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在VA的TeleSleep项目中，邮寄与亲自PAP启动的有效性。

研究目的：本研究旨在评估远程医疗设置是否优于面对面设置的退伍军人开始PAP治疗。方法：在两个VA卫生系统中确定COVID-19大流行前后的PAP设置。远程医疗PAP设置发生在2020年3月至2021年12月之间。现场PAP设置发生在2019年1月至12月之间。提取第1-30天（第1个月）和60-90天（第3个月）的PAP数据。比较现场和远程医疗的PAP使用情况，利用每晚使用的小时数、使用的天数（30天内）和剩余AHI（在依从性用户中）。使用以下非劣效性裕度进行非劣效性分析：使用小时45分钟，使用天数4天，剩余AHI每小时5次。结果：纳入432例接受PAP设置的VA患者（93.5%男性）(224人；208远程医疗)。PAP在第1个月的使用情况（90% CI=-0.31,0.53）和第3个月（90% CI=-0.18, 0.71）、第1个月的使用天数（90% CI=-2.28, 1.33）和第3个月（90% CI=-1.75, 2.20）以及第1个月（90% CI=-0.40, 1.62）和第3个月（90% CI=-0.69, 2.30）的残留AHI均无劣效性。结论：在使用退伍军人护理的退伍军人中，通过远程医疗启动PAP治疗的依从性不逊于现场就诊。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Sleep Medicine CLINICAL NEUROLOGY-

CiteScore

6.20

自引率

7.00%

发文量

321

审稿时长

1 months

期刊介绍： Journal of Clinical Sleep Medicine focuses on clinical sleep medicine. Its emphasis is publication of papers with direct applicability and/or relevance to the clinical practice of sleep medicine. This includes clinical trials, clinical reviews, clinical commentary and debate, medical economic/practice perspectives, case series and novel/interesting case reports. In addition, the journal will publish proceedings from conferences, workshops and symposia sponsored by the American Academy of Sleep Medicine or other organizations related to improving the practice of sleep medicine.