Impact of the COVID-19 pandemic on positive airway pressure adherence and patients' perspectives in Greece: the role of telemedicine.

ABSTRACT

STUDY OBJECTIVES: To analyze the impact of national lockdowns in Greece on positive airway pressure (PAP) adherence, patients' perspectives regarding COVID-19 pandemic and the role of telemedicine. METHODS: 872 obstructive sleep apnea (OSA) patients from Southern and 673 from Northern Greece, under PAP treatment, were evaluated with adherence data available 12 months prior to and 3 months after the first and second lockdown. Telemedicine, locally available as part of a research protocol, was used for patient's follow-up in Southern Greece and standard follow up procedures were implemented in Northern Greece. We analyzed the impact of COVID-19 lockdown on PAP adherence, and patients concerns regarding COVID-19 infection. RESULTS: Significant difference was noted in PAP adherence as measured by the hours of use at 12 months prior to and at the 3 months after the first lockdown in Southern (5.6 vs 6.6, p=0.003) and Northern Greece (5.3 vs 6.0, p=0.03). The proportion of patients with optimal adherence (≥6 hours) increased by 18% (p=0.004) in Southern and by 9% (p=0.20) in Northern Greece after the first lockdown and remained steady after the second lockdown in both groups. In Southern Greece, 23% of patients reported that they were concerned about getting COVID-19 due to OSA diagnosis, while only 3% reported decreased sleep duration. Moreover, 9% were concerned that the presence of OSA would make them more susceptible for worse outcome in case of COVID-19 infection. CONCLUSIONS: Our results suggest that maintaining follow-up using telemedicine had a positive influence pointing out the potential role of digital health.