0512 Does Patient And Family Engagement Improve Positive Airway Pressure Use In Patients With Obstructive Sleep Apnea? A Randomized Controlled Trial. (12th April 2019)

• Record Type: Journal Article
• Authors: Khan, Nazia Naz S; Olomu, Adesuwa; Bottu, Shireesha; Najafkouchak, Azam; Todem, David; Badr, Safwan
• Is Part Of: Sleep. Volume 42(2019)Supplement 1
• Page Start: A205
• Page End: A205
• Publication Date: 2019-04-12
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsz067.510
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Despite clear Positive Airway Pressure (PAP) benefits, nearly 25% of users discontinue PAP within 2 weeks and 50% do so within 1 year. We sought to assess the impact of patient and family engagement in improving PAP adherence in OSA patients. Methods: Pilot randomized controlled trial (RCT), patients aged ≥18 years with a new diagnosis of OSA, who qualified for PAP treatment, and living with a partner/parent, were randomized to Intervention group (ITG) (n=28) and Attention Control Group (ACG) (n=32). Both groups participated in a 60-90 minutes group visit (1-3 subjects with their partner/visit). Intervention group visit included four-structured sessions: interactive education, peer coaching, hands-on experience and semi-structured one-on-two motivational interview. ACG patients with their partner were educated on physical activity only. Objective PAP adherence data were obtained at 3-and-6 months. Correlated data models were used to compare temporal changes in the mean daily usage (MDU) and proportion of PAP adherence (PAP use ≥ 4 hours/night on 70% of nights) during the three-time intervals between the two groups. Results: ACG had a consistent decrease in MDU (hours/day) from baseline to 3 months (d= −0.3) and 3-6 months (d= −0.67, p=0.07) unlike their ITG counterparts whose mean remained relatively constant (p=0.76). There was no difference in the change in proportion of PAP adherence (p= 0.84) and in the intention to use (ITU) PAP at 3-and-6 months (p=0.15). There was an unstable spike in the ACG in the ITU at 3 months (p=0.03) unlike ITG whose rates remained constant throughout (p=0.64). Conclusion: This is the largest and longest RCT of patient and partner intervention to improve PAP use. Our intervention kept the patients motivated to continue to use their PAP at the same rate as baseline whereas PAP adherence declined with time in patients undergoing standard education and counseling. Our findings suggest that additional intervention is needed to improve the PAP use in OSA. Support (If Any): Funded by the Sparrow Health System/Michigan State University Center for Innovation and Research.