According to a new study, users of Philips Respironics' SleepMapper app were 22 percent more adherent to continuous positive airway pressure (CPAP) therapy than non-users.
SleepMapper is an app and website platform from Philips for patients with sleep apnea who are already using CPAP therapy, which involves a face mask that blows air into a patient's upper airway while she sleeps. The system, which launched just over a year ago, allows patients to see the data generated by the machine and presents them with goals and feedback to increase adherence.
Fewer than half of those patients prescribed CPAP continue to use it after the first year, and an oft-cited study from 1993 found that the majority of CPAP users don’t use it as prescribed. Still, symptoms can improve if patients use CPAP for about 4.5 hours a night. SleepMapper aims to change that status quo with an established behavior change protocol called Motivational Enhancement Therapy.
To do the study, Philips analyzed 15,000 de-identified patient records from EncoreAnywhere, a database of use data collected from Philips Respironics CPAP machines. Half of the patients had downloaded and used SleepMapper, while half of them had not. Researchers then analyzed the data to compare the percent of patients in each group who met Center for Medicare and Medicaid Services standards for treatment adherence, that the patient used the device four or more hours per night over 70 percent of the nights across a 30-day consecutive period within the first 90 days of treatment.
Philips found that overall, only 56 percent of the non-SleepMapper users met the CMS guidelines, whereas 78 percent of SleepMapper users did, a difference of 22 percent. They used the machine 1.4 hours more per night by day 90, on average. They also looked at subsets of users that were more or less adherent generally. In the group of patients that used the therapy over the full 90 days, SleepMapper gave only a 10 percent boost -- from 74 percent adherence to 84, with an extra 0.6 hours of use per night on average. In the group classified as "struggling," who averaged less than two hours a night of usage in the first two weeks of treatment, CMS adherence for SleepMapper users was 33 percent, compared to 11 percent of non-users.
The CMS guidelines aren't an arbitrary measure, as they represent the standard of adherence many users would have to meet in order to have their insurance pay for their sleep apnea treatment.
"CMS criteria for adherence are important, as payers are now implementing similar guidelines across the US and many believe that similar approaches will be taken across the world," the study authors write. "Such guidelines require patients to utilize therapy to a set criterion, with proof of adherence, in order to receive reimbursement for their therapy. Our analysis suggests that motivational tools and techniques such as those included in the SleepMapper application and website create a unique opportunity to better engage patients and enable them to help themselves throughout the course of therapy."