Study Objectives:

The aim of the Improving CPAP Adherence Program (I-CAP study) was to assess the impact of a multidimensional treatment framework based on shared decision-making, patient activation, and caregiver engagement on improving long-term positive airway pressure (PAP) adherence in patients newly diagnosed with obstructive sleep apnea (OSA).

Methods:

In this pilot study, patients aged ≥ 18 years with new OSA diagnosis, who qualified for PAP treatment and lived with a caregiver, were randomly assigned to receive either the multidimensional treatment (intervention, n=28) or unrelated education (control group, n=32). All patients and their caregivers participated in a group visit. The intervention group attended four structured sessions: interactive education, peer coaching, hands-on experience, and a semi-structured motivational interview. The control group was educated on physical activity and lifestyle only. Objective PAP adherence data were obtained at baseline (day received PAP machine to group visit), group visit-3 months, and 3-6 months.

Results:

In an age-adjusted model, the mean daily use (MDU) of PAP increased significantly over the three time periods (p=0.03). Intervention-arm participants gained a mean 1.23 (CI: 0.33 - 2.13) hour in PAP MDU between 3 and 6 months, vs. that of the control arm (p=0.008). We saw no difference in the percentage of PAP adherence across time between the two arms.

Conclusions:

A multifaceted patient-centered intervention with caregiver engagement improved PAP adherence vs. control levels, a beneficial effect sustained for the 6 months. Our findings suggest that caregivers, with the appropriate training, can improve patients' PAP adherence by providing a socially supportive environment.

中文翻译：

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患者和家庭参与对改善阻塞性睡眠呼吸暂停患者持续气道正压通气依从性的影响：一项随机对照试验

学习目标：

改善 CPAP 依从性计划（I-CAP 研究）的目的是评估基于共享决策、患者激活和护理人员参与的多维治疗框架对改善长期气道正压通气 (PAP) 依从性的影响新诊断为阻塞性睡眠呼吸暂停 (OSA) 的患者。

方法：

在这项初步研究中，年龄 ≥ 18 岁、新诊断为 OSA、符合 PAP 治疗条件并与照顾者同住的患者被随机分配接受多维治疗（干预，n=28）或无关教育（对照组，n =32）。所有患者及其护理人员都参加了集体访问。干预组参加了四个结构化的会议：互动教育、同伴辅导、实践经验和半结构化动机访谈。对照组仅接受体育活动和生活方式方面的教育。目标 PAP 依从性数据在基线（接受 PAP 机器到组访问的天数）、3 个月和 3-6 个月的组访问中获得。

结果：

在年龄调整模型中，PAP 的平均每日使用量 (MDU) 在三个时间段内显着增加 (p=0.03)。与对照组相比，干预组参与者在 3 到 6 个月之间在 PAP MDU 中平均增加了 1.23 (CI：0.33 - 2.13) 小时 (p=0.008)。我们发现两臂之间随时间变化的 PAP 依从性百分比没有差异。

结论：

与护理者接合的多方面的以患者为中心的干预改善PAP粘附VS。控制水平，有益效果持续了 6 个月。我们的研究结果表明，经过适当培训的护理人员可以通过提供社会支持的环境来提高患者的 PAP 依从性。