OSA treatment with positive airway pressure reduces economic burden in HFpEF

In patients with heart failure with preserved ejection fraction (HFpEF) and comorbid obstructive sleep apnoea (OSA), positive airway pressure (PAP) therapy helps lower the use of healthcare resource, according to a study.

For the study, researchers used administrative insurance claims data linked with objective PAP therapy usage data involving 4,237 patients (mean age 64.1 years, 54.0 percent women) with OSA and HFpEF. One‐year PAP adherence was defined according to an adapted US Medicare definition. Propensity score methods were applied to create groups with similar characteristics across PAP adherence levels.

During the first year of PAP therapy, 40 percent of patients were considered adherent, 30 percent had intermediate adherence, and 30 percent were nonadherent. Patients who were adherent to PAP therapy used the device on 6.6 days per week for 7.2 hours per use day, while those with intermediate adherence used PAP on 3.8 days per week for 5.4 hours per use day. Finally, nonadherent patients used PAP on 0.9 day per week for 2.9 hours per use day.

PAP adherence was associated with fewer healthcare resource use compared with nonadherence, with a 57-percent decrease in hospitalizations and a 36-percent decrease in emergency room visits relative to the year before PAP initiation.

Additionally, total healthcare costs were significantly lower for PAP-adherent patients than nonadherent patients (USD 12,732 vs 15,610; p<0.001).

Outcomes associated with intermediate adherence to PAP were largely similar to those associated with nonadherence.

The present data underscore the importance of managing concomitant OSA in patients with HFpEF, as well as highlight the need for strategies to enhance PAP adherence in this population.