Adherence to positive airway pressure therapy and healthcare resource utilization and costs among patients with obstructive sleep apnea and obesity

作者：Fatima H. Sert Kuniyoshi, Ann Cameron, Jean‐Louis Pépin, R Benjamin Dexter, Caleb Woodford, Peter A. Cistulli, Naomi Alpert, K L Sterling, Atul Malhotra, on behalf of the medXcloud group · 发表于：International Journal of Obesity · 年份：2026 · DOI：10.1038/s41366-025-01985-1 · 被引用次数：4 · 研究领域：Obstructive Sleep Apnea Research、Tracheal and airway disorders、Chronic Obstructive Pulmonary Disease (COPD) Research

OBJECTIVE: Obstructive sleep apnea (OSA) and obesity are highly prevalent comorbid conditions associated with major societal and healthcare burden. Positive airway pressure (PAP) therapy is the first-line treatment for OSA. This study evaluated the association between PAP adherence and healthcare resource utilization (HCRU) and costs in patients with OSA and comorbid obesity. METHODS: ) newly diagnosed with OSA who initiated PAP between 2015 and 2021. Patients were categorized based on adherence: adherent (met Medicare criteria for all quarters), intermediate (adherent for at least one quarter), or nonadherent. Primary outcomes included all-cause emergency room (ER) visits and hospitalizations. Healthcare costs, including inpatient, ER, and total costs, were secondary outcomes. Inverse probability of treatment weighting was applied to balance baseline characteristics across adherence groups. RESULTS: Among 173,691 patients, 35.2% were adherent, 39.1% intermediately adherent, and 25.7% nonadherent. After applying inverse probability of treatment weighting (IPTW), in year 1 post-index, adherent patients had significantly fewer ER visits and hospitalizations (0.55 ± 1.77 and 0.10 ± 0.44) compared to nonadherent patients (0.69 ± 1.78 and 0.14 ± 0.56; P < 0.001), and significantly lower total healthcare costs (11,332 ± 21,160 vs 11,927 ± 20,212; P < 0.001). Similar findings were observed after 2 years of therapy with adherent patients having lower HCRU and costs than nonadherent p...