A pilot study of CPAP adherence promotion by peer buddies with sleep apnea

Abstract

Study objectives: To evaluate patient ratings of the acceptability of a peer buddy system (PBS). To promote continuous positive airway pressure (CPAP) therapy adherence in patients with obstructive sleep apnea (OSA). To obtain preliminary data on the effectiveness of PBS on sleep-specific health-related quality of life and CPAP adherence.

Design: Prospective, randomized, and controlled study.

Setting: Academic Center.

Participants: Thirty-nine patients with OSA and 13 patients with OSA who were experienced CPAP users.

Interventions: Recently diagnosed patients with OSA were randomly assigned to either the PBS to promote CPAP adherence (intervention group) or usual care (control group).

Measurements: Patient satisfaction, Functional Outcomes of Sleep Questionnaire (FOSQ), CPAP adherence, vigilance, self-efficacy, and patient activation were measured.

Results: Ninety-one percent of the subjects rated the PBS as very satisfactory (68%) or satisfactory (23%). During the 90 days of therapy, weekly CPAP adherence was greater in the intervention than the usual care group (MANOVA; F = 2.29; p = 0.04). Patient satisfaction was positively correlated with CPAP adherence (R(2) = 0.14; p = 0.02). We did not find any group differences for FOSQ, vigilance, self-efficacy, or patient activation in this pilot study.

Conclusion: Our pilot study suggests that the PBS intervention is feasible and received high patient satisfaction ratings. CPAP adherence may be improved by peer-driven intervention, but a larger, adequately powered study is needed.

Clinical trial information: ClinicalTrials.gov identifier: NCT01164683.

Commentary: A commentary on this article appears in this issue on page 551.

Citation: Parthasarathy S; Wendel C; Haynes PL; Atwood C; Kuna S. A pilot study of CPAP adherence promotion by peer buddies with sleep apnea. J Clin Sleep Med 2013;9(6):543-550.

Keywords: Adherence; adherence; adult; artificial respiration; compliance; continuous positive airway pressure; obstructive sleep apnea; sleep apnea.

Figures

Figure 1. Patient flow in the protocol as per CONSORT guidelines

Figure 2. Adherence to continuous positive airway pressure (CPAP) therapy

Expressed as the mean (SD) minutes of CPAP use per day. Subjects assigned to peer buddy system (PBS, closed circles) versus usual care (open circles) is shown for each week of therapy during the 3 months of follow-up. During the 90 days of therapy, Wilks lambda multivariate test of overall differences revealed greater CPAP adherence in the intervention than the usual care group (MANOVA; F = 2.29; p = 0.04).