TY - JOUR
T1 - Socioeconomic Factors and Adherence to CPAP
T2 - The Population-Based Course of Disease in Patients Reported to the Swedish CPAP Oxygen and Ventilator Registry Study
AU - Palm, Andreas
AU - Grote, Ludger
AU - Theorell-Haglöw, Jenny
AU - Ljunggren, Mirjam
AU - Sundh, Josefin
AU - Midgren, Bengt
AU - Ekström, Magnus
N1 - Publisher Copyright:
© 2021 The Authors
PY - 2021/10
Y1 - 2021/10
N2 - Background: Early identification of poor adherence to CPAP treatment is of major clinical importance to optimize treatment outcomes in patients with OSA. Research Question: How do socioeconomic factors influence CPAP adherence? Study Design and Methods: Nationwide, population-based cohort study of patients with OSA receiving CPAP treatment reported to the Swedish quality registry Swedevox between 2010 and 2018 was cross-linked with individual socioeconomic data from Statistics Sweden. Socioeconomic factors associated with CPAP adherence were identified using a multivariate linear regression model, adjusted for age and sex. Results: In total, 20,521 patients were included: 70.7% men; mean age ± SD, 57.8 ± 12.2 years; BMI, 32.0 ± 6.1 kg/m2; apnea-hypopnea index, 36.9 ± 22.1; Epworth Sleepiness Scale, 10.4 ± 5.0; and median nocturnal CPAP use, 355 min (interquartile range, 240-420 min). Adherence after 1.3 ± 0.8 years of CPAP use was significantly (all P <.001) associated with civil status (married vs unmarried: +20.5 min/night), education level (high, ≥ 13 years vs low, ≤ 9 years: +13.2 min/night), total household income (highest/third/second vs lowest quartile: +15.9 min/night, +10.4 min/night, and +6.1 min/night, respectively), and country of birth (born in Sweden with one native parent/born in Sweden with two native parents vs being born abroad: +29.0 min/night and +29.3 min/night, respectively). Interpretation: Civil status, educational level, household income, and foreign background predict CPAP adherence in a clinically significant manner and should be considered when treating OSA with CPAP.
AB - Background: Early identification of poor adherence to CPAP treatment is of major clinical importance to optimize treatment outcomes in patients with OSA. Research Question: How do socioeconomic factors influence CPAP adherence? Study Design and Methods: Nationwide, population-based cohort study of patients with OSA receiving CPAP treatment reported to the Swedish quality registry Swedevox between 2010 and 2018 was cross-linked with individual socioeconomic data from Statistics Sweden. Socioeconomic factors associated with CPAP adherence were identified using a multivariate linear regression model, adjusted for age and sex. Results: In total, 20,521 patients were included: 70.7% men; mean age ± SD, 57.8 ± 12.2 years; BMI, 32.0 ± 6.1 kg/m2; apnea-hypopnea index, 36.9 ± 22.1; Epworth Sleepiness Scale, 10.4 ± 5.0; and median nocturnal CPAP use, 355 min (interquartile range, 240-420 min). Adherence after 1.3 ± 0.8 years of CPAP use was significantly (all P <.001) associated with civil status (married vs unmarried: +20.5 min/night), education level (high, ≥ 13 years vs low, ≤ 9 years: +13.2 min/night), total household income (highest/third/second vs lowest quartile: +15.9 min/night, +10.4 min/night, and +6.1 min/night, respectively), and country of birth (born in Sweden with one native parent/born in Sweden with two native parents vs being born abroad: +29.0 min/night and +29.3 min/night, respectively). Interpretation: Civil status, educational level, household income, and foreign background predict CPAP adherence in a clinically significant manner and should be considered when treating OSA with CPAP.
KW - adherence
KW - CPAP
KW - OSA
KW - socioeconomic factors
U2 - 10.1016/j.chest.2021.04.064
DO - 10.1016/j.chest.2021.04.064
M3 - Article
C2 - 33971148
AN - SCOPUS:85115932494
SN - 0012-3692
VL - 160
SP - 1481
EP - 1491
JO - Chest
JF - Chest
IS - 4
ER -