1077 Optimizing Message Delivery in Tele-monitoring to Patients at 90 Days: The Tele-OSA Randomized Clinical Trial

Abstract Introduction The Tele-OSA study previously reported the impact of CPAP tele-monitoring(TM) with automated patient feedback[U-Sleep; ResMed Corp] on improving 3-month CPAP adherence. We analyzed daily usage patterns to determine patient response to received messages. Methods Tele-OSA was a 4-arm randomized trial conducted at Kaiser Permanente sleep center(Fontana, CA) studying patients with suspected OSA. The primary outcome(3-month CPAP adherence) revealed improved use with TM but no significant impact with telemedicine-delivered education. TM involved automatic wireless upload of CPAP data followed by automated patient messages(text, email, and/or phone) if CPAP use decreased below a defined threshold or for achieving Medicare compliance. We randomly selected 28 patients with severe OSA that received both TM and tele-education, evaluated daily usage, and tagged specific days messages were delivered. Results 28 subjects(75.0% male, 50.5 ± 12.0 years, AHI 49.6 ± 19.8, CPAP 90-day usage 285.0 ± 152.0 minutes, 9.2 ± 7.7 messages sent). 10 had “high” adherence(≥70% days with ≥4 hours usage); 11 had “mid” adherence(≥40 to