COMMunication and Education for the New CPAP Experience (COMMENCE)
2017年9月29日 更新者：Faith Luyster、University of Pittsburgh
COMMENCE Study: COMMunication and Education for the New CPAP Experience
The purpose of this research study is to examine the effect of a couple-oriented education and support intervention on patient- and partner -reported outcomes (positive airway pressure (PAP) adherence) in patients newly diagnosed with obstructive sleep apnea (OSA).
調査の概要
状態
完了
条件
詳細な説明
Continuous positive airway pressure (CPAP) therapy is an effective treatment for obstructive sleep apnea (OSA), but adherence is poor.
CPAP adherence interventions to date have been met with limited success.
Intervention strategies would be optimized by added support for patients and alternative strategies for intervention delivery.
Significant others (SO) are likely to exert positive and negative effects on the patient's adoption and use of positive airway pressure (PAP) therapy and are frequently described as the greatest source of social support for patients with chronic illness.
Beginning the intervention before PAP initiation would capitalize on the teachable moment shortly following diagnosis when education and social support may be most essential.
The aims of the research plan are to examine the effects of a couple-oriented education and support intervention on patient- and partner-reported outcomes as compared to a patient-oriented education and support intervention and usual care and to examine the relationship between PAP adherence and patients' and partners' sleep quality and daytime functioning.
Patients in the pilot study will be randomized to the couple-oriented intervention, patient-oriented intervention, or standard clinical care group.
研究の種類
介入
入学 (実際)
60
段階
- 適用できない
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
-
-
Pennsylvania
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Pittsburgh、Pennsylvania、アメリカ、15261
- University of Pittsburgh
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-
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
21年歳以上 (大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
Inclusion Criteria:
Patient:
- Age is 21 years of age and older
- Have spouse or partner
- Polysomnographically (PSG) diagnosed OSA (AHI ≥ 5)
- Choice of continuous positive airway pressure (CPAP) as preferred treatment
Partner:
- Age is 18 years of age and older
- Have spouse or partner who has been diagnosed with OSA and has chosen CPAP as preferred treatment
Exclusion Criteria:
Patient:
- AHI < 5 on the diagnostic PSG
- Have a spouse or partner with OSA diagnosis and on OSA treatment
- Past treatment for OSA
- Diagnosis of a sleep disorder other than OSA that cause arousals from sleep (e.g., central sleep apnea, periodic limb movement disorder, insomnia)
- Diagnosis of a serious medical condition (e.g., end stage renal failure, severe chronic obstructive lung disease, severe asthma)
- History of or current diagnosis of a major psychiatric illness except depression (e.g., schizophrenia, bipolar disorder) partner:
- Have been diagnosed with OSA and using CPAP
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：支持療法
- 割り当て：ランダム化
- 介入モデル：階乗代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：Patients in the Couple-oriented intervention
Patients randomly assigned to the couple-oriented (CO) group will attend two face to face sessions with their partner and participate in an individual telephone follow-up session.
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The first session will occur before the patient receives his/her CPAP and will last approximately 2 hours.
This session will provide the couple with education on sleep apnea and CPAP and information on different types of PAP therapy and cleaning procedures, explore patient's concerns about starting CPAP treatment, and provide a goal setting exercise.
The second face to face session will occur one week after the patient receives his/her CPAP and will last approximately one and a half hours.
The second session will provide the couple with information on CPAP usage and pre- and post-treatment AHI, explore barriers to CPAP use and benefits of CPAP use, and provide a goal setting exercise.
The individual telephone follow-up sessions will occur two weeks after the patient has received his/her CPAP and will last approximately 20 minutes.
This session will review CPAP usage and explore barriers and facilitators of CPAP use.
CPAP is treatment for obstructive sleep apnea.
CPAP therapy keeps the airway open during the night by providing a stream of air through a mask that is worn while sleeping.
|
|
他の：Patients in Usual Care
Patients will not attend any intervention sessions.
|
CPAP is treatment for obstructive sleep apnea.
CPAP therapy keeps the airway open during the night by providing a stream of air through a mask that is worn while sleeping.
|
|
実験的：Patients in the Patient-oriented intervention
Patients randomly assigned to the patient-oriented (PT) group will attend two face to face sessions and participate in a telephone follow-up session.
|
CPAP is treatment for obstructive sleep apnea.
CPAP therapy keeps the airway open during the night by providing a stream of air through a mask that is worn while sleeping.
The first session will occur before the patient receives his/her CPAP and will last approximately one and a half hours.
This session will provide the patient with education on sleep apnea and CPAP and information on different types of PAP therapy and cleaning procedures, explore patient's concerns about starting CPAP treatment, and provide a goal setting exercise.
The second face to face session will occur one week after the patient receives his/her CPAP and will last approximately 45 minutes.
The second session will provide information on CPAP usage and pre- and post-treatment AHI, explore barriers to CPAP use and benefits of CPAP use, and provide a goal setting exercise.
The telephone follow-up session will occur two weeks after the patient has received his/her CPAP and will last approximately 20 minutes.
This session will review CPAP usage and explore barriers and facilitators of CPAP use.
|
|
実験的：Partners in the Couple-oriented intervention
Partners randomly assigned to the couple-oriented (CO) group will attend two face to face sessions with the patient and participate in an individual telephone follow-up session.
|
The first session will occur before the patient receives his/her CPAP and will last approximately 2 hours.
This session will provide the couple with education on sleep apnea and CPAP and information on different types of PAP therapy and cleaning procedures, explore patient's concerns about starting CPAP treatment, and provide a goal setting exercise.
The second face to face session will occur one week after the patient receives his/her CPAP and will last approximately one and a half hours.
The second session will provide the couple with information on CPAP usage and pre- and post-treatment AHI, explore barriers to CPAP use and benefits of CPAP use, and provide a goal setting exercise.
The individual telephone follow-up sessions will occur two weeks after the patient has received his/her CPAP and will last approximately 20 minutes.
This session will review CPAP usage and explore barriers and facilitators of CPAP use.
|
|
他の：Partners in Usual Care
Partners will not attend any intervention sessions.
|
No intervention will be received.
|
|
実験的：Partners in the Patient-oriented intervention
Partners randomly assigned to the patient-oriented (PT) group will not attend any intervention sessions.
|
The first session will occur before the patient receives his/her CPAP and will last approximately one and a half hours.
This session will provide the patient with education on sleep apnea and CPAP and information on different types of PAP therapy and cleaning procedures, explore patient's concerns about starting CPAP treatment, and provide a goal setting exercise.
The second face to face session will occur one week after the patient receives his/her CPAP and will last approximately 45 minutes.
The second session will provide information on CPAP usage and pre- and post-treatment AHI, explore barriers to CPAP use and benefits of CPAP use, and provide a goal setting exercise.
The telephone follow-up session will occur two weeks after the patient has received his/her CPAP and will last approximately 20 minutes.
This session will review CPAP usage and explore barriers and facilitators of CPAP use.
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Daytime Sleepiness
時間枠：baseline and 3 months after CPAP initiation
|
The Epworth Sleepiness Scale is an 8-item questionnaire that assesses daytime sleepiness.Total scores range from 0 to 24.
A score of > 10 indicates excessive daytime sleepiness.
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baseline and 3 months after CPAP initiation
|
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Sleep-related Functional Outcomes
時間枠：baseline and 3 months after CPAP initiation
|
The Functional Outcomes of Sleep Questionnaire-10 is 10-item questionnaire assesses the impact of sleep disorders of excessive sleepiness on multiple activities of everyday living.
Scores for five domains of functioning (e.g., activity, vigilance, intimacy and sexual relationships, general productivity, and social outcome) are obtained.
Each domain score ranges from 1 to 4 (1 indicating more difficulty).
The total score is derived by calculating the mean of the domain scores and multiplying by five.
The total score ranges from 5 to 20, with higher scores indicating greater functioning.
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baseline and 3 months after CPAP initiation
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Sleep Quality
時間枠：baseline and 3 months after CPAP initiation
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The Pittsburgh Sleep Quality Index (PSQI) is a 19 item questionnaire that measures self-reported sleep quality and disturbances over the last 1 month time period.
The questionnaire measures 7 components of sleep quality: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction.
A global PSQI score is obtained by summing the 7 component scores (range = 0-21).
A PSQI global score > 5 indicates a poor sleeper.
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baseline and 3 months after CPAP initiation
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Continuous Positive Airway Pressure (CPAP) Adherence
時間枠：one week, one month, and 3 months after CPAP initiation
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Adherence will be measured as the amount of time that the CPAP machine is turned on and maintained at prescribed pressure.
The latter number represents the amount of time power is on and the mask is positioned properly on the face.
All patients will be using a CPAP machine with remote monitoring capabilities.
Adherence reports are automatically uploaded to a secure data center daily.
Adherence data can be accessed through the web-based patient compliance management system, EncoreAnywhere.
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one week, one month, and 3 months after CPAP initiation
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
スポンサー
捜査官
- 主任研究者：Faith S Luyster, PhD、University of Pittsburgh
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
一般刊行物
- Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986 Jan;24(1):67-74. doi: 10.1097/00005650-198601000-00007.
- Weaver TE, Maislin G, Dinges DF, Bloxham T, George CF, Greenberg H, Kader G, Mahowald M, Younger J, Pack AI. Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep. 2007 Jun;30(6):711-9. doi: 10.1093/sleep/30.6.711.
- Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991 Dec;14(6):540-5. doi: 10.1093/sleep/14.6.540.
- Aloia MS, Arnedt JT, Riggs RL, Hecht J, Borrelli B. Clinical management of poor adherence to CPAP: motivational enhancement. Behav Sleep Med. 2004;2(4):205-22. doi: 10.1207/s15402010bsm0204_3.
- Weaver TE, Kribbs NB, Pack AI, Kline LR, Chugh DK, Maislin G, Smith PL, Schwartz AR, Schubert NM, Gillen KA, Dinges DF. Night-to-night variability in CPAP use over the first three months of treatment. Sleep. 1997 Apr;20(4):278-83. doi: 10.1093/sleep/20.4.278.
- Weaver TE, Laizner AM, Evans LK, Maislin G, Chugh DK, Lyon K, Smith PL, Schwartz AR, Redline S, Pack AI, Dinges DF. An instrument to measure functional status outcomes for disorders of excessive sleepiness. Sleep. 1997 Oct;20(10):835-43.
- Berg CA, Upchurch R. A developmental-contextual model of couples coping with chronic illness across the adult life span. Psychol Bull. 2007 Nov;133(6):920-54. doi: 10.1037/0033-2909.133.6.920.
- Hoy CJ, Vennelle M, Kingshott RN, Engleman HM, Douglas NJ. Can intensive support improve continuous positive airway pressure use in patients with the sleep apnea/hypopnea syndrome? Am J Respir Crit Care Med. 1999 Apr;159(4 Pt 1):1096-100. doi: 10.1164/ajrccm.159.4.9808008.
- Aloia MS, Arnedt JT, Stepnowsky C, Hecht J, Borrelli B. Predicting treatment adherence in obstructive sleep apnea using principles of behavior change. J Clin Sleep Med. 2005 Oct 15;1(4):346-53.
- Stepnowsky CJ Jr, Marler MR, Ancoli-Israel S. Determinants of nasal CPAP compliance. Sleep Med. 2002 May;3(3):239-47. doi: 10.1016/s1389-9457(01)00162-9.
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- Cartwright R. Sleeping together: a pilot study of the effects of shared sleeping on adherence to CPAP treatment in obstructive sleep apnea. J Clin Sleep Med. 2008 Apr 15;4(2):123-7.
- Baron KG, Smith TW, Berg CA, Czajkowski LA, Gunn H, Jones CR. Spousal involvement in CPAP adherence among patients with obstructive sleep apnea. Sleep Breath. 2011 Sep;15(3):525-34. doi: 10.1007/s11325-010-0374-z. Epub 2010 Jun 15.
- Baron KG, Smith TW, Czajkowski LA, Gunn HE, Jones CR. Relationship quality and CPAP adherence in patients with obstructive sleep apnea. Behav Sleep Med. 2009;7(1):22-36. doi: 10.1080/15402000802577751.
- Bazzano LA, Khan Z, Reynolds K, He J. Effect of nocturnal nasal continuous positive airway pressure on blood pressure in obstructive sleep apnea. Hypertension. 2007 Aug;50(2):417-23. doi: 10.1161/HYPERTENSIONAHA.106.085175. Epub 2007 Jun 4.
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研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始
2014年3月1日
一次修了 (実際)
2016年7月1日
研究の完了 (実際)
2016年7月1日
試験登録日
最初に提出
2011年6月17日
QC基準を満たした最初の提出物
2011年6月17日
最初の投稿 (見積もり)
2011年6月21日
学習記録の更新
投稿された最後の更新 (実際)
2017年10月2日
QC基準を満たした最後の更新が送信されました
2017年9月29日
最終確認日
2017年9月1日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。