Evidence map›Paper›PMID 35347655›Full record

ArticleSleep & breathing = Schlaf & Atmung2023

Impact of mail-based continuous positive airway pressure initiation on treatment usage and effectiveness.

Lucas M Donovan, Elizabeth C Parsons, Catherine A McCall, Ken He, Rahul Sharma, Justina Gamache, Anna P Pannick, Jennifer A McDowell, James Pai, Eric Epler and 6 more

Open access · bronzeAbstract read
In one paragraph

Article in Sleep & breathing = Schlaf & Atmung, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 57% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Effectiveness of mailed versus in-person PAP initiation in the Veterans Affairs' TeleSleep program.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 1 country.

Lucas M DonovanHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA. ldonovan@uw.edu.
Elizabeth C ParsonsHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Catherine A McCallHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Ken HeHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Rahul SharmaHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Justina GamacheHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Anna P PannickHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Jennifer A McDowellHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
James PaiHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Eric EplerHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Kevin I DuanHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Laura J SpeceHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Laura C FeemsterHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Vishesh K KapurUniversity of Washington, Seattle, WA, USA.
David H AuHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
Brian N PalenHSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Division of Pulmonary, Critical Care and Sleep Medicine, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, 98108, USA.
University of Washington · USVA Puget Sound Health Care System · USSeattle University · US

Funding

CATALyST: Consortium for Applied Training to Advance the Learning health system with Scholars/TraineesK12HS026369 · AHRQ · KAISER FOUNDATION RESEARCH INSTITUTE · PI LOZANO, PAULA, RALSTON, JAMES D. · 2018 to 2022
$3.5M
Redesigning Medical specialty Outpatient DELivery through virtual SLEEP care (REMODEL-SLEEP)IK2HX002816 · VA · VA PUGET SOUND HEALTHCARE SYSTEM · PI DONOVAN, LUCAS MATTHEW · 2020 to 2024
–
AHRQ HHS K12 HS026369HSRD VA IK2 HX002816
6 · The paper itself

Abstract

purposeIn-person visits with a trained therapist have been standard care for patients initiating continuous positive airway pressure (CPAP). These visits provide an opportunity for hands-on training and an in-person assessment of mask fit. However, to improve access, many health systems are shifting to remote CPAP initiation with equipment mailed to patients. While there are potential benefits of a mailed approach, relative patient outcomes are unclear. Specifically, many have concerns that a lack of in-person training may contribute to reduced CPAP adherence. To inform this knowledge gap, we aimed to compare treatment usage after in-person or mailed CPAP initiation.

methodsOur medical center shifted from in-person to mailed CPAP dispensation in March 2020 during the COVID-19 pandemic. We assembled a cohort of patients with newly diagnosed obstructive sleep apnea (OSA) who initiated CPAP in the months before (n = 433) and after (n = 186) this shift. We compared 90-day adherence between groups.

resultsMean nightly PAP usage was modest in both groups (in-person 145.2, mailed 140.6 min/night). We did not detect between-group differences in either unadjusted or adjusted analyses (adjusted difference - 0.2 min/night, 95% - 27.0 to + 26.5).

conclusionsMail-based systems of CPAP initiation may be able to improve access without reducing CPAP usage. Future work should consider the impact of mailed CPAP on patient-reported outcomes and the impact of different remote setup strategies.

Indexed as

Continuous Positive Airway PressureCOVID-19CognitionHumansPandemicsPostal ServiceAdherenceCare pathwaysContinuous positive airway pressureObstructive sleep apneaRemote careSleep medicine

Identifiers

PMID35347655
PMCPMC8960106
OpenAlexW4221103644

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.