Treatment Adherence Decreases Risk of Rehospitalization in Adults With OSA, CVD
Consistent use of continuous positive airway pressure (CPAP) treatment in patients with known cardiovascular disease (CVD) and newly diagnosed obstructive sleep apnea (OSA) may be associated with a lower possibility of rehospitalization.
To assess the effect of CPAP adherence on 30-day hospital readmission, a retrospective cohort study was conducted among Medicare beneficiaries aged 65 years or older with pre-existing CVD who were newly diagnosed with OSA between 2009-2013, initiated CPAP, and were hospitalized. The primary outcome was 30-day hospital readmission. The authors placed the study participants into three categories: non-adherent participants had less than 4 machine charges, partially adherent participants had 4 to 12 machine charges, and highly adherent participants had more than 12 machine charges, all during the 25 months of follow up.
Among 1301 individuals meeting the study criteria, the average age was 73 years, and 53% were men. The 30-day readmission rate during the 2-year period following CPAP initiation was 10.2%. Of the sample study, 33.0% had low CPAP adherence, 38.0% had partial adherence, and 28.5% had high adherence.
Relative to low adherence, Medicare beneficiaries with high adherence were 60% less likely to be readmitted to the hospital within 30 days. The protective effect of high CPAP adherence on 30-day readmission was significant among beneficiaries with heart failure (OR 0.50; 95% CI 0.16 - 0.79), but not among those with other CVD.
The authors concluded, “In this nationally representative sample of older adults with CVD and comorbid OSA, high CPAP adherence was associated with lower odds of 30-day readmission. These results highlight the importance of screening for and treating OSA among individuals with CVD.”
— Yvette C Terrie, BS, Pharm, R.Ph.
Bailey MD, Wickwire EM, Somers VK, Albrecht JS. Adherence to continuous positive airway pressure reduces the risk of 30-day hospital readmission among older adults with comorbid obstructive sleep apnea and cardiovascular disease. J Clin Sleep Med. 2022;10.5664/jcsm.10196. doi:10.5664/jcsm.10196