Where to Next for Optimizing Adherence in Large-Scale Trials of Continuous Positive Airway Pressure? - 21/01/21

Doi : 10.1016/j.jsmc.2020.10.007

Amy M. Sawyer, PhD, RN ^a,^b,^c,^⁎ , Douglas M. Wallace, MD ^d,^e, Luis F. Buenaver, PhD ^f, Alexa J. Watach, PhD, RN ^c,^g, Amy Blase, CCRA ^h, Bruno Saconi, MS, RN ⁱ, Sanjay R. Patel, MD, MS ^j, Samuel T. Kuna, MD ^c,^k, Naresh M. Punjabi, MD, PhD ^l
^a Department of Biobehavioral Health Science, University of Pennsylvania School of Nursing, 418 Curie Boulevard, Claire Fagin Hall, Room 349, Philadelphia, PA 19104, USA
^b Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
^c University of Pennsylvania Perelman School of Medicine, Center for Sleep and Circadian Neurobiology, Philadelphia, PA, USA
^d Department of Neurology, Sleep Medicine Division, University of Miami Miller School of Medicine, 1201 Northwest 16th Street, Room A212, Miami, FL 33125, USA
^e Miami Veterans Affairs HealthCare System, Miami, FL, USA
^f Johns Hopkins Behavioral Sleep Medicine Program, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 100, Baltimore, MD 21224-6823, USA
^g University of Pennsylvania School of Nursing, 418 Curie Boulevard, Claire Fagin Hall, Room 349, Philadelphia, PA 19104, USA
^h ResMed Corporation, 9001 Spectrum Center Boulevard, San Diego, CA 92123, USA
ⁱ University of Pennsylvania School of Nursing, 418 Curie Boulevard, Claire Fagin Hall, Philadelphia, PA 19104, USA
^j Center for Sleep and Cardiovascular Outcomes Research, University of Pittsburgh, 3609 Forbes Avenue, 2nd Floor, Room 108, Pittsburgh, PA 15213, USA
^k Sleep Medicine, Sleep Medicine Section (111P), Corporal Michael J. Crescenz Veterans Affairs Medical Center, 3900 Woodland Avenue, Philadelphia, PA 19104, USA
^l Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami, Miller School of Medicine, 1951 NW 7th Avenue, Miami, FL 33136, USA

^∗Corresponding author. Department of Biobehavioral Health Science, University of Pennsylvania School of Nursing, 418 Curie Boulevard, Claire Fagin Hall, Room 349, Philadelphia, PA 19104.Department of Biobehavioral Health ScienceUniversity of Pennsylvania School of Nursing418 Curie BoulevardClaire Fagin HallRoom 349PhiladelphiaPA19104

Résumé

Large-scale randomized trials of positive airway pressure (PAP) efficacy have been largely negative but PAP adherence was notably suboptimal across the trials. To address this limitation, evidence-based PAP adherence protocols embedded within the larger trial protocol are recommended. The complexity of such protocols depends on adequacy of resources, including funding and inclusion of behavioral scientist experts on the scientific team, and trial-specific considerations (eg, target population) and methods. Recommendations for optimizing PAP adherence in large-scale trials are set forth that address rigor and reproducibility.

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Keywords : Obstructive sleep apnea, Continuous positive airway pressure, Patient compliance, Health behavior, Telemedicine, Health education, Controlled clinical trial, Behavioral economics

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Vol 16 - N° 1

P. 125-144 - mars 2021 Retour au numéro

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Where to Next for Optimizing Adherence in Large-Scale Trials of Continuous Positive Airway Pressure? - 21/01/21

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