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
{"title":"在VA的TeleSleep项目中，邮寄与亲自PAP启动的有效性。","authors":"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","doi":"10.5664/jcsm.11692","DOIUrl":null,"url":null,"abstract":"<p><strong>Study objectives: </strong>This study sought to evaluate whether telehealth set-up was non-inferior to in-person set-up for veterans initiating PAP therapy.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":""},"PeriodicalIF":3.5000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of mailed versus in-person PAP initiation in VA's TeleSleep program.\",\"authors\":\"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\",\"doi\":\"10.5664/jcsm.11692\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study objectives: </strong>This study sought to evaluate whether telehealth set-up was non-inferior to in-person set-up for veterans initiating PAP therapy.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":50233,\"journal\":{\"name\":\"Journal of Clinical Sleep Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-04-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Sleep Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5664/jcsm.11692\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Sleep Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5664/jcsm.11692","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Effectiveness of mailed versus in-person PAP initiation in VA's TeleSleep program.
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.
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.
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