Accessibility and adherence to positive airway pressure treatment in patients with obstructive sleep apnea: a multicenter study in Latin America

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dc.contributor.authorNogueira, Juan Facundo
dc.contributor.authorPoyares, Dalva
dc.contributor.authorSimonelli, Guido
dc.contributor.authorLeiva, Sebastián
dc.contributor.authorCarrillo-Alduenda, José Luis
dc.date.accessioned2021-08-19T15:35:40Z
dc.date.available2021-08-19T15:35:40Z
dc.date.issued2020
dc.description.abstractPurpose Information on access and adherence to positive airway pressure (PAP) treatment is lacking at the regional level in Latin America. This study characterized access and adherence to PAP in patients with moderate-severe obstructive sleep apnea (OSA) in Latin America. Methods Cross-sectional study, conducted at 9 sleep centers across Argentina, Brazil, Chile, Colombia, Mexico, and Peru. Adults diagnosed with moderate-severe OSA (apnea-hypopnea index [AHI] ≥ 15/h) in the previous 12–18 months were eligible. Anthropometrics, health coverage, and OSA severity data were collected. Data on access to therapy, barriers to access, adherence, and factors related to non-compliance were obtained via standardized telephone survey. Results Eight hundred eighty patients (70% male, 54 ± 13 years, AHI 49 ± 28/h, body mass index 32 ± 7 kg/m2 ) were included. Four hundred ninety patients (56%) initiated PAP, 70 (14%) discontinued therapy during the first year (mainly due to intolerance), and 420 (48%) were still using PAP when surveyed. Health insurance was private in 36.9% of patients, via the social security system in 31.1%, and via the state in 13.3%, and 18.7% did not have any coverage; 49.5% of patients had to pay all equipment costs. Reasons for not starting PAP were unclear or absent indication (42%), coverage problems (36%), and lack of awareness of OSA burden (14%). Patients with better adherence were older (55.3 ± 13 vs 52 ± 13; p = 0.002) and had more severe OSA (AHI 51.8 ± 27 vs 45.6 ± 27; p = 0.001). Conclusions Less than half moderate-severe OSA patients started and continue to use PAP. Unclear or absent medical indication and financial limitations were the most relevant factors limiting access to therapy.es
dc.identifier.citationSleep and Breathing, 2020, vol. 24:455–464es
dc.identifier.urihttps://doi.org/10.1007/s11325-019-01881-9es
dc.identifier.urihttp://hdl.handle.net/11447/4367
dc.language.isoenes
dc.subjectObstructive sleep apneaes
dc.subjectContinuous positive airway pressurees
dc.subjectCompliance to treatmentes
dc.subjectLatin Americaes
dc.titleAccessibility and adherence to positive airway pressure treatment in patients with obstructive sleep apnea: a multicenter study in Latin Americaes
dc.typeArticlees

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