From CPAP Prescription to Long-Term Follow-Up: Care Pathway, Adherence, and Multidomain Treatment Outcomes in Obstructive Sleep Apnea
- 1Respiratory Medicine Unit, Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Largo L.A. Scuro, 10, 37134 Verona, Italy
Abstract
Background/Objectives: Long-term continuous positive airway pressure (CPAP) management involves both engagement with care and sustained treatment outcomes. We aimed to characterize long-term follow-up attendance, longitudinal adherence, and multidomain treatment outcomes in patients with obstructive sleep apnea (OSA). Methods: We studied 172 adults with OSA who entered a real-world CPAP care pathway. Long-term attendance was evaluated among patients with ≥30 months of potential follow-up from CPAP prescription, with 24- and 36-month thresholds examined in sensitivity analyses. Longitudinal adherence and multidomain outcomes were assessed among patients with available follow-up data. Results: Among 114 patients in the primary long-term follow-up risk set, 80 (70.2%) attended; attendance was similar using 24- and 36-month thresholds (68.5% and 72.8%). Older age was associated with greater attendance (odds ratio 1.58 per 10-year increase, 95% confidence interval 1.10–2.28). Among 94 patients with paired adherence data, adherence according to available device-recorded nights was 78.7% at first and 79.8% at long-term follow-up, although 11.7% changed adherence category. At long-term assessment, device-recorded CPAP adherence, device-derived respiratory control (predefined residual apnea-hypopnea index [AHI] < 5 events/hour criterion), absence of residual sleepiness, and perceived treatment benefit were observed in 79.8%, 47.8%, 87.8%, and 89.3% of patients with available data, respectively. Among 71 patients with complete multidomain data, 45.1% simultaneously met all four predefined treatment-domain criteria, increasing to 63.4% using residual AHI < 10 events/hour. Conclusions: Care-pathway attendance and treatment outcomes represent distinct dimensions of long-term CPAP management. Similar aggregate adherence according to available device-recorded nights across assessments may conceal individual differences in adherence classification between observation intervals, while treatment outcomes are only partially concordant. Multidimensional reassessment may therefore identify clinically relevant discordance beyond adherence alone.
Related
- Mediterranean Diet Adherence Tools in Post-Treatment Breast Cancer Survivors: A Scoping Review of Measurement Approaches and Associated Outcomes.
- Medication Adherence in Patients With Glaucoma and Determinants of Treatment Adherence: A Cross-Sectional Study
- Linking prevention and adherence: a behavioural study on treatment compliance to preventing TB transmission
- Effects of podcast supported multicomponent education on treatment adherence and self care management in patients with hypertension
- Human dignity and its associations with self efficacy and treatment adherence in adults with type 2 diabetes in Iran
BibTeX
@article{sartori2026from,
title = {{From CPAP Prescription to Long-Term Follow-Up: Care Pathway, Adherence, and Multidomain Treatment Outcomes in Obstructive Sleep Apnea}},
author = {Giulia Sartori and Rosaria Caprino and Ernesto Crisafulli},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15218296},
url = {https://www.mdpi.com/2077-0383/15/21/8296},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - From CPAP Prescription to Long-Term Follow-Up: Care Pathway, Adherence, and Multidomain Treatment Outcomes in Obstructive Sleep Apnea
AU - Giulia Sartori
AU - Rosaria Caprino
AU - Ernesto Crisafulli
PY - 2026
DA - 2026/10/24
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218296
UR - https://www.mdpi.com/2077-0383/15/21/8296
AB - Background/Objectives: Long-term continuous positive airway pressure (CPAP) management involves both engagement with care and sustained treatment outcomes. We aimed to characterize long-term follow-up attendance, longitudinal adherence, and multidomain treatment outcomes in patients with obstructive sleep apnea (OSA). Methods: We studied 172 adults with OSA who entered a real-world CPAP care pathway. Long-term attendance was evaluated among patients with ≥30 months of potential follow-up from CPAP prescription, with 24- and 36-month thresholds examined in sensitivity analyses. Longitudinal adherence and multidomain outcomes were assessed among patients with available follow-up data. Results: Among 114 patients in the primary long-term follow-up risk set, 80 (70.2%) attended; attendance was similar using 24- and 36-month thresholds (68.5% and 72.8%). Older age was associated with greater attendance (odds ratio 1.58 per 10-year increase, 95% confidence interval 1.10–2.28). Among 94 patients with paired adherence data, adherence according to available device-recorded nights was 78.7% at first and 79.8% at long-term follow-up, although 11.7% changed adherence category. At long-term assessment, device-recorded CPAP adherence, device-derived respiratory control (predefined residual apnea-hypopnea index [AHI] < 5 events/hour criterion), absence of residual sleepiness, and perceived treatment benefit were observed in 79.8%, 47.8%, 87.8%, and 89.3% of patients with available data, respectively. Among 71 patients with complete multidomain data, 45.1% simultaneously met all four predefined treatment-domain criteria, increasing to 63.4% using residual AHI < 10 events/hour. Conclusions: Care-pathway attendance and treatment outcomes represent distinct dimensions of long-term CPAP management. Similar aggregate adherence according to available device-recorded nights across assessments may conceal individual differences in adherence classification between observation intervals, while treatment outcomes are only partially concordant. Multidimensional reassessment may therefore identify clinically relevant discordance beyond adherence alone.
SN - 2077-0383
ER -