Dados do Trabalho

Título

EFFECTIVENESS OF TELEMONITORING IN A PUBLIC VENTILATORY SUPPORT PROGRAM

Introdução

Sleep disorders (SDB) are all events related to the respiratory system that occur during sleep, including obstructive sleep apnea (OSA), and hypoventilation syndromes. Positive pressure therapy (PAP) is the preferred treatment for SDB and can be performed using continuous positive airway pressure (CPAP) or two pressure levels (bilevel). Adherence to treatment is crucial for therapeutic effectiveness, however many patients may have difficulties adapting to PAP. Telemonitoring is an important tool for improving adherence by providing real-time data on device usage, facilitating personalized settings and ongoing support.

Objetivo

To analyze data regarding adherence to short- and long-term positive pressure treatment in patients treated at a SUS sleep clinic.

Métodos

This is a retrospective study of data referring to four years of telemonitoring in a sleep physiotherapy outpatient clinic from 2020 to 2023. The telemonitoring model uses 2G technology through a cellular signal (GSM) in a database in cloud, following a protocol of teleconsultations carried out 7, 15, 30, 60 and 90 days after the start of therapy. After initial adherence, teleconsultations are carried out every three to six months, depending on the level of adherence and adaptation to therapeutic pressure. Telemonitoring of data is followed by a phone call to analyze residual symptoms and possible therapeutic adjustments. The target for defining adherence to the treatment was the use of more than four hours per night on at least 70% of nights. Initial adherence represents the first three months of use of the equipment and late adherence, the last three months of use.

Resultados

A total of 29,069 telemonitorings were carried out over the 4 years, reaching an average of 7,267 telemonitorings/year and 605 telemonitorings/month. The therapeutic modality used was 84.3% CPAP, 4% bilevel (S mode) and 11.7% bilevel ( ST, T or PC modes). The average age was 54.41± 19.33 years and the average initial adherence over the 4 years was 79.4%, varying annually from 79.6%(2020), 82.3%(2021), 80 .4%(2022) and 78%(2023). Late adherence in 4 years was 69.7%, varying annually 70.92% (2020), 70% (2021), 69.5% (2022) and 66.9% (2023). A total of 1136 patients achieved the early adherence goal and 1015 patients maintained the late adherence goal.

Conclusões

interventions based on telemonitoring are associated with an increase in adherence to therapy

Palavras -chave

Treatment Adherence,Obstructive Sleep Apnea,Continuous Positive Airway Pressure