0544 The Impact of Telemedicine on Continuous Positive Airway Pressure Adherence in Obstructive Sleep Apnea Patients

Abstract Introduction Telemedicine has grown in popularity among patients for initial sleep medicine consultation following the COVID-19 pandemic. We sought to evaluate whether initial telemedicine consultation adversely impacted CPAP adherence over the initial 90 days of use among patients diagnosed with obstructive sleep apnea (OSA). Methods We reviewed the medical records of all patients initiated on CPAP therapy between January and May of 2023 at three academic sleep clinics at the University of Pittsburgh Medical Center. We compared CPAP adherence at 90 days between patients whose initial evaluation was done via telemedicine versus an in-person visit. Logistic regression was used to compare the odds of achieving Centers for Medicare & Medicaid Services (CMS) adherence criteria for long-term coverage accounting for age, sex, and race. Results A total of 289 patients were initiated on CPAP during the period studied with 141 (48.8%) having a telemedicine consult and 148 (51.2%) having an in-person visit. The cohort had a mean age 52 +/- 15 yrs, 38% were women, 76% were White and 18% were Black with no significant differences between the two groups. There was no difference in the percentage of patients achieving CMS criteria for long-term coverage (72.4% with telemedicine vs. 69.3% with in-person, p=0.95). Similarly, mean nightly usage over 90 days (261 ± 12 min with telemedicine vs. 243 ± 13 min with in-person, p=0.31) and percent of nights with more than 4 hours of CPAP use (60.0 ± 2.8% with telemedicine vs. 55.4 ± 2.9% with in-person, p=0.26) did not differ between groups. Results were similar when stratified by sex and did not change when adjusted for age, sex, and race. Conclusion Clinical outcomes in the treatment of OSA are not inferior in patients evaluated via telemedicine. Given the convenience of telemedicine for many patients, particularly those living in rural areas and those with limited ability to take time off from work or access transportation, greater use of telemedicine can expand access to OSA care without reducing the quality of care. Support (if any) none