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Socioeconomic Factors and Adherence to CPAP : The Population-Based Course of Disease in Patients Reported to the Swedish CPAP Oxygen and Ventilator Registry Study

Palm, Andreas ; Grote, Ludger ; Theorell-Haglöw, Jenny ; Ljunggren, Mirjam ; Sundh, Josefin ; Midgren, Bengt LU and Ekström, Magnus LU orcid (2021) In Chest 160(4). p.1481-1491
Abstract

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... (More)

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.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adherence, CPAP, OSA, socioeconomic factors
in
Chest
volume
160
issue
4
pages
11 pages
publisher
American College of Chest Physicians
external identifiers
  • pmid:33971148
  • scopus:85115932494
ISSN
0012-3692
DOI
10.1016/j.chest.2021.04.064
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 The Authors
id
b788a389-4f16-4b63-9bf5-72d40b19ec27
date added to LUP
2021-10-21 11:32:15
date last changed
2025-02-23 19:19:47
@article{b788a389-4f16-4b63-9bf5-72d40b19ec27,
  abstract     = {{<p>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/m<sup>2</sup>; 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 &lt;.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.</p>}},
  author       = {{Palm, Andreas and Grote, Ludger and Theorell-Haglöw, Jenny and Ljunggren, Mirjam and Sundh, Josefin and Midgren, Bengt and Ekström, Magnus}},
  issn         = {{0012-3692}},
  keywords     = {{adherence; CPAP; OSA; socioeconomic factors}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{1481--1491}},
  publisher    = {{American College of Chest Physicians}},
  series       = {{Chest}},
  title        = {{Socioeconomic Factors and Adherence to CPAP : The Population-Based Course of Disease in Patients Reported to the Swedish CPAP Oxygen and Ventilator Registry Study}},
  url          = {{http://dx.doi.org/10.1016/j.chest.2021.04.064}},
  doi          = {{10.1016/j.chest.2021.04.064}},
  volume       = {{160}},
  year         = {{2021}},
}