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Sleep Med. 2018 Jan;41:20-26. doi: 10.1016/j.sleep.2017.07.026. Epub 2017 Sep 9.

Effect of a patient engagement tool on positive airway pressure adherence: analysis of a German healthcare provider database.

Author information

Sleep and Ventilation Center Blaubeuren, Lung Center Ulm, Ulm, Germany. Electronic address:
Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Germany.
ResMed Science Center, ResMed Germany, Martinsried, Germany.
Charité - Universitätsmedizin Berlin, Centrum für Herz- Kreislauf- und Gefäßmedizin, Interdisziplinäres Schlafmedizinisches Zentrum, Berlin, Germany.
Department of Sleep Medicine and Neuromuscular Disorders, University of Münster, Münster, Germany.
Department of Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Department of Respiratory Medicine, Allergology and Sleep Medicine, General Hospital Nuremberg, Nuremberg, Germany; Paracelsus Medical University, Nuremberg, Germany.



This study investigated the addition of a real-time feedback patient engagement tool on positive airway pressure (PAP) adherence when added to a proactive telemedicine strategy.


Data from a German healthcare provider (ResMed Healthcare Germany) were retrospectively analyzed. Patients who first started PAP therapy between 1 September 2009 and 30 April 2014, and were managed using telemedicine (AirView™; proactive care) or telemedicine + patient engagement tool (AirView™ + myAir™; patient engagement) were eligible. Patient demographics, therapy start date, sleep-disordered breathing indices, device usage hours, and therapy termination rate were obtained and compared between the two groups.


The first 500 patients managed by telemedicine-guided care and a patient engagement tool were matched with 500 patients managed by telemedicine-guided care only. The proportion of nights with device usage ≥4 h was 77 ± 25% in the patient engagement group versus 63 ± 32% in the proactive care group (p < 0.001). Therapy termination occurred less often in the patient engagement group (p < 0.001). The apnea-hypopnea index was similar in the two groups, but leak was significantly lower in the patient engagement versus proactive care group (2.7 ± 4.0 vs 4.1 ± 5.3 L/min; p < 0.001).


Addition of a patient engagement tool to telemonitoring-guided proactive care was associated with higher device usage and lower leak. This suggests that addition of an engagement tool may help improve PAP therapy adherence and reduce mask leak.


Adherence; Compliance; Patient engagement; Positive airway pressure; Telemonitoring

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