1110 Utilizing Consumer Wearables to Empower and Engage Patients Prescribed non-PAP Obstructive Sleep Apnea Therapy

Abstract Introduction Increased adoption of consumer wearables has resulted in abundant patient-generated health data (PGHD). However, guidance on incorporation of metrics from such devices in the management of sleep disorders is lacking. We aimed to develop a PGHD program, using continuous oxygen saturation (SpO2) monitoring from a consumer wearable as a prototype. By implementing SpO2 data and patient survey outcomes in reports, we engaged patients prescribed non-PAP therapy for obstructive sleep apnea (OSA) and promoted shared decision making to enhance therapy. Methods In an ongoing quality improvement project at a VA medical center, we conducted three plan-do-study-act (PDSA) cycles. Patients share SpO2 data collected with a clinic-issued Fitbit via a third-party platform (Fitabase), OSA patient-reported outcome (PRO) measures and their nightly use of non-PAP therapy via Qualtrics. We created a report that juxtaposes SpO2 distribution, PRO measures, and therapy compliance and then send it to the patient for review. At cycle end, patients meet with a sleep clinician to discuss the reports, OSA therapy, and program feedback. Results Eleven patients aged 30 to 85 have enrolled (3-5 per cycle). In Cycle 1 (7 days), we developed orientation procedures and patient-facing materials and refined the process for merging the SpO2, PRO, and patient-reported therapy use into a graphical and textual report. A majority of patients (67%, n=6 of 9) indicated motivation to retrial PAP therapy after seeing low SpO2 values. We developed a standardized script to clearly explain the report and data for our patients. In Cycle 2 (14 days), we tested the standardized script and troubleshot barriers to accessing data that emerged— ie unexplained gaps in SpO2 values and device sync issues. In Cycle 3 (28 days), we revised the graphs to reduce production time. Eight patients completed the post program survey. When asked if they would recommend the program (scale 1-10; 10 best), the average score was 9.25. Conclusion We developed a consumer wearable based program to engage patients in OSA treatment. Incorporating oxygen data from wearables may promote self-management and participation in shared decision making, which ultimately may improve health outcomes of OSA. Support (if any) VA Office of Connected Care