Objective/background: 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. Patients/methods: 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. Results: 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). Conclusions: 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