A Tailored Intervention for PAP Adherence: The SCIP-PA Trial.
Journal
Behavioral sleep medicine
ISSN: 1540-2010
Titre abrégé: Behav Sleep Med
Pays: England
ID NLM: 101149327
Informations de publication
Date de publication:
Historique:
pubmed:
28
1
2017
medline:
22
6
2019
entrez:
28
1
2017
Statut:
ppublish
Résumé
Positive airway pressure (PAP) is highly efficacious treatment but nonadherence is prevalent with little improvement over the last 15 years. Tailored interventions show promise for promoting adherence to other treatments. The study objective was to examine feasibility and acceptability of a tailored intervention to promote PAP adherence. The convenience sample met inclusion criteria: newly diagnosed OSA; treatment-naïve; ≥ 18 years. previous obstructive sleep apnea (OSA) diagnosis and treatment; new psychiatric diagnosis; use of oxygen/bilevel PAP; secondary sleep disorder. Adults (n = 118) were randomized to tailored intervention (TI; n = 61) or usual care (UC; n = 57); application of a priori exclusion criteria resulted in 30 participants per assignment who were middle-aged (51.3 ± 11.1 years) adults (70% male) with severe OSA (apnea hypopnea index [AHI], 35.9 ± 25.2). Randomized, double-blind, single-site pilot controlled trial. A multiphased tailored intervention targeting social cognitive perceptions of OSA-PAP treatment was delivered at four intervals. Descriptive analysis, group differences, and self-efficacy change scores by t-test, and thematic analysis of acceptability data are reported. One-week PAP use among TI was 35 min greater than UC condition (p = 0.20; Cohen's d = 0.336). Treatment use decreased at 1 month and 3 months (NS). Per-protocol delivery of face-to-face intervention delivery was 100% but lower for telephone intervention delivery. Personalized approach was valued by participants. A tailored intervention approach is acceptable to participants and feasibly implemented in a clinical sleep center setting. The intervention effect size at 1 week is consistent with other educational PAP adherence interventions but was not sustained; further pilot testing is warranted to address pilot RCT limitations.
Sections du résumé
OBJECTIVE/BACKGROUND
Positive airway pressure (PAP) is highly efficacious treatment but nonadherence is prevalent with little improvement over the last 15 years. Tailored interventions show promise for promoting adherence to other treatments. The study objective was to examine feasibility and acceptability of a tailored intervention to promote PAP adherence.
PARTICIPANTS
The convenience sample met inclusion criteria: newly diagnosed OSA; treatment-naïve; ≥ 18 years.
EXCLUSION CRITERIA
previous obstructive sleep apnea (OSA) diagnosis and treatment; new psychiatric diagnosis; use of oxygen/bilevel PAP; secondary sleep disorder. Adults (n = 118) were randomized to tailored intervention (TI; n = 61) or usual care (UC; n = 57); application of a priori exclusion criteria resulted in 30 participants per assignment who were middle-aged (51.3 ± 11.1 years) adults (70% male) with severe OSA (apnea hypopnea index [AHI], 35.9 ± 25.2).
METHODS
Randomized, double-blind, single-site pilot controlled trial. A multiphased tailored intervention targeting social cognitive perceptions of OSA-PAP treatment was delivered at four intervals. Descriptive analysis, group differences, and self-efficacy change scores by t-test, and thematic analysis of acceptability data are reported.
RESULTS
One-week PAP use among TI was 35 min greater than UC condition (p = 0.20; Cohen's d = 0.336). Treatment use decreased at 1 month and 3 months (NS). Per-protocol delivery of face-to-face intervention delivery was 100% but lower for telephone intervention delivery. Personalized approach was valued by participants.
CONCLUSIONS
A tailored intervention approach is acceptable to participants and feasibly implemented in a clinical sleep center setting. The intervention effect size at 1 week is consistent with other educational PAP adherence interventions but was not sustained; further pilot testing is warranted to address pilot RCT limitations.
Identifiants
pubmed: 28128977
doi: 10.1080/15402002.2016.1276018
pmc: PMC5529283
mid: NIHMS850010
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
49-69Subventions
Organisme : NINR NIH HHS
ID : R00 NR011173
Pays : United States
Organisme : NHLBI NIH HHS
ID : T32 HL007953
Pays : United States
Organisme : NINR NIH HHS
ID : T32 NR009356
Pays : United States
Références
Indian J Med Res. 2010 Feb;131:245-58
pubmed: 20308750
Behav Sleep Med. 2004;2(4):205-22
pubmed: 15600056
Sleep. 1995 Apr;18(3):158-66
pubmed: 7610311
Sleep Med Rev. 2014 Apr;18(2):123-39
pubmed: 23725820
Proc Am Thorac Soc. 2008 Feb 15;5(2):136-43
pubmed: 18250205
Sleep. 1999 Aug 1;22(5):667-89
pubmed: 10450601
Chest. 2005 Aug;128(2):624-33
pubmed: 16100147
Int J Nurs Stud. 2012 Jan;49(1):40-6
pubmed: 21924424
Am J Respir Crit Care Med. 2012 Jul 15;186(2):190-4
pubmed: 22610391
Am J Respir Crit Care Med. 2013 Jun 1;187(11):1259-66
pubmed: 23725615
Sleep. 2003 Sep;26(6):727-32
pubmed: 14572127
Sleep Breath. 2014 Dec;18(4):875-83
pubmed: 24595715
Chest. 1993 Jan;103(1):30-6
pubmed: 8417909
Eur Respir Rev. 2013 Sep 1;22(129):353-64
pubmed: 23997062
N Engl J Med. 2015 Feb 26;372(9):793-5
pubmed: 25635347
J Am Coll Cardiol. 2008 Aug 19;52(8):686-717
pubmed: 18702977
Sleep. 1997 Apr;20(4):278-83
pubmed: 9231953
BMJ. 2008 Sep 29;337:a1655
pubmed: 18824488
Sleep. 2007 Jun;30(6):711-9
pubmed: 17580592
Sleep. 2009 Dec;32(12):1549-58
pubmed: 20041590
Am J Epidemiol. 2006 Mar 15;163(6):493-501
pubmed: 16443796
J Clin Sleep Med. 2013 Jun 15;9(6):543-50
pubmed: 23772186
Sleep. 2009 Jul;32(7):915-9
pubmed: 19639754
Nat Sci Sleep. 2011 Jul 26;3:87-99
pubmed: 23616720
Cochrane Database Syst Rev. 2014 Jan 08;(1):CD007736
pubmed: 24399660
Thorax. 2008 Oct;63(10):860-5
pubmed: 18408048
Can Respir J. 2008 Apr;15(3):159-65
pubmed: 18437259
Sleep. 2007 Mar;30(3):320-4
pubmed: 17425228
Chest. 2014 Sep;146(3):600-610
pubmed: 24810282
J Consult Clin Psychol. 2012 Feb;80(1):151-63
pubmed: 22103957
Am J Respir Crit Care Med. 2004 Aug 15;170(4):371-6
pubmed: 15142866
Health Educ Behav. 2004 Apr;31(2):143-64
pubmed: 15090118
Am J Respir Crit Care Med. 2014 Jun 15;189(12):1544-50
pubmed: 24673616
Am J Respir Crit Care Med. 2002 May 1;165(9):1217-39
pubmed: 11991871
Thorax. 2008 Jun;63(6):536-41
pubmed: 18234904
Am J Epidemiol. 2013 May 1;177(9):1006-14
pubmed: 23589584
Res Theory Nurs Pract. 2006 Winter;20(4):317-24
pubmed: 17190118
Sleep. 2006 Mar;29(3):375-80
pubmed: 16553024
Chest. 2016 Aug;150(2):337-45
pubmed: 27018174
Sleep. 2011 Jan 01;34(1):111-9
pubmed: 21203366
Sleep Breath. 2013 May;17(2):791-801
pubmed: 22945541
J Clin Sleep Med. 2014 Apr 15;10(4):355-62
pubmed: 24733978
Behav Sleep Med. 2007;5(3):229-40
pubmed: 17680733
J Clin Sleep Med. 2009 Jun 15;5(3):263-76
pubmed: 19960649
Br J Psychiatry. 2005 Jan;186:11-7
pubmed: 15630118
Expert Rev Respir Med. 2008 Jun 1;2(3):349-364
pubmed: 19690624
Am Rev Respir Dis. 1993 Apr;147(4):887-95
pubmed: 8466125
Sleep. 2013 Nov 01;36(11):1655-62
pubmed: 24179298
J Clin Sleep Med. 2013 Mar 15;9(3):199-205
pubmed: 23493772
Res Theory Nurs Pract. 2007;21(4):271-85
pubmed: 18236771
Arch Intern Med. 2006 May 8;166(9):977-84
pubmed: 16682570
Am J Prev Med. 2003 Nov;25(4):308-14
pubmed: 14580632
Sleep. 1997 Oct;20(10):835-43
pubmed: 9415942
BMJ. 2002 Jul 13;325(7355):92-4
pubmed: 12114242
Chest. 2006 Dec;130(6):1772-8
pubmed: 17166995
Sleep. 1994 Dec;17(8):703-10
pubmed: 7701181