Efficiency of a phone coaching program on adherence to continuous positive airway pressure in sleep apnea hypopnea syndrome: a randomized trial

Kamila Sedkaoui, Ludivine Leseux, Sandrine Pontier, Nicole Rossin, Paul Leophonte, Jean-Louis Fraysse, Alain Didier, Kamila Sedkaoui, Ludivine Leseux, Sandrine Pontier, Nicole Rossin, Paul Leophonte, Jean-Louis Fraysse, Alain Didier

Abstract

Background: Continuous Positive Airway Pressure (CPAP) remains the reference treatment for moderate to severe forms of the Sleep Apnea/Hypopnea Syndrome (SAHS). Compliance to the treatment appears to be a key factor to improving health status of these patients.

Methods: We conducted a multicenter, prospective, randomized, controlled, parallel group trial of standard support completed or not within 3 months of coaching sessions for newly diagnosed SAHS patients starting CPAP therapy. This study has been recorded by AFSSAPS with the RCB number: 2009-A01127-50 and received favourably by the Human Studies Committee in France. The coaching session consisted of 5 sessions of telephone-based counselling by competent staff. The primary outcome was the proportion of patients using CPAP more than 3 h per night for 4 months; the secondary outcome was mean hours of CPAP usage in the 2 groups.

Results: Three hundred and seventy-nine patients fulfilled the inclusion criteria and were randomized. The percentage of patients using CPAP more than 3 h per night for 4 months was 65 % for the standard support group and 75 % for the coached group. This difference reached a statistical significance (χ2 = 3.97). The mean CPAP usage was increased in the coached group versus standard group. A difference of 26 min was observed (4 h34+/-2 h17 and 4 h08+/-2 h25 respectively, p = 0.04).

Conclusion: This study shows that SAHS patients who benefit from phone coaching are statistically more compliant to CPAP than a standard support group is. A simple phone coaching procedure based on knowledge of the disease and reinforcement messages about treatment benefits helps to improve CPAP adherence in SAHS patients.

Trial registration: NCT02435355.

Figures

Fig. 1
Fig. 1
Design of study
Fig. 2
Fig. 2
CONSORT flow diagram
Fig. 3
Fig. 3
Proportion of patients used CPAP more than 3 h per night for 4 months in coached group (black line) versus standard group (grey line)
Fig. 4
Fig. 4
Mean CPAP use (in minutes) for 4 months for patients in coached group (black line) versus standard group (grey line). *p <0.05
Fig. 5
Fig. 5
Mean CPAP use (in minutes) for 4 months for subgroups of patient in coached group (black lines) or in standard group (grey line). *p <0.05; **p <0.005

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Source: PubMed

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