• REVAMP: A prospective study on the impact of virtual medicine on CPAP compliance and satisfaction of care

      Lee, David; The University of Arizona College of Medicine - Phoenix; Pineda, Lilibeth (The University of Arizona., 2021)
      Although continuous positive airway pressure (CPAP) is the gold standard treatment for the chronic sleep disorder, obstructive sleep apnea (OSA), compliance with the CPAP machine among patients continues to be a challenge. REVAMP (Remote Veterans Apnea Management Platform) is a personalized, interactive web platform and mobile app that enables veterans to be evaluated for their OSA and better optimize their management of OSA. REVAMP aims to improve transparency and access to healthcare, reduce patient burdens of traveling and wait times, and establishes better communication with patients and their healthcare team. The purpose of this project was to assess whether the utilization of REVAMP improves the compliance of CPAP for rural Arizona veterans diagnosed with OSA compared to veterans who do not use any additional aide or intervention for their CPAP machine. From 2016 to 2020 for patients from the Phoenix VA Health Care System, 50 patients were randomly selected for a control population and 51 patients were randomly selected from the population enrolled in REVAMP with CPAP compliance as the primary outcome measured. CPAP compliance is defined as 30 nights of CPAP usage for >=4 hours per night at least 70% of nights used. CPAP compliance data came from each patient’s CPAP machine that has its data collected via a wireless modem and stored onto the REVAMP or Resmed Airview platforms that are accessed by a secure VA account. The REVAMP population presented an overall 60.8% compliance rate compared to the 24.0% overall CPAP compliance rate for the control population. The REVAMP mean CPAP usage (%) was found to be 75.2 +/- 33.0 compared to the control population with mean CPAP usage (%) 45.1 +/- 40.4 (p < 0.0001) and a mean CPAP usage >=4 hours per night (%) as 62.5 +/- 37.1 compared to the control population of mean CPAP usage >=4 hours per night (%) as 32.6 +/- 37.4 (p < 0.0001). Based on these findings, there is strong evidence to suggest that interventions like REVAMP that increase education, transparency, and communication with a patient’s healthcare team increase compliance rates for treatments like CPAP. It is also possible that patients who enroll in REVAMP are a self-selecting population who are more motivated to seek out interventions to improve their condition, and further studies should investigate such manners.