Effects of Augmented Continuous Positive Airway Pressure Education and Support on Compliance and Outcome in a Chinese Population

Hui, David; Chan, Joseph Yat Sun; Choy, D.; Ko, Fanny W.S.; Li, Thomas S.T.; Leung, Roland; Lai, Ching‐Long

doi:10.1378/chest.117.5.1410

Cited by 132 publications

(112 citation statements)

References 29 publications

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“…They have used different didactical approaches not clearly based on perceived learning needs of the patients and have shown conflicting results [30], [31], [32], [33], [34], [35], [36] and [37]. Group education seems promising [30], [33], [35] and [36].…”

Section: Discussionmentioning

confidence: 99%

“…Another study using verbal education in small groups improved knowledge about sleep apnoea [33]. Video education showed limited effects on knowledge [32] and adherence [31], even when written information about OSAS and CPAP, as well as telephone support was added [31]. On the other hand, a 15 min educational video during the initial visit improved the return rate to a CPAP clinic after 1 month [34].…”

Section: Discussionmentioning

confidence: 99%

“…Other factors of importance in the educational situation, not included in the above-mentioned studies [30], [31], [32], [33], [34], [35], [36] and [37], or measured in our study, can be behavioural aspects, such as motivation, self-determination and the process of creating a habit of using the CPAP treatment. Drieschner et al [39] described motivation to engage in treatment as dependent on six cognitive and emotional internal determinants: problem recognition, level of suffering, external pressure, perceived cost of treatment, perceived suitability of treatment, outcome expectancy, motivation to engage in treatment, and treatment engagement.…”

Section: Discussionmentioning

confidence: 99%

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Perceived informational needs, side-effects and their consequences on adherence—A comparison between CPAP treated patients with OSAS and healthcare personnel

Broström

Strömberg

Ulander

et al. 2009

Patient Education and Counseling

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ObjectiveTo compare perceptions among continuous positive airway pressure (CPAP) treated patients with obstructive sleep apnoea syndrome (OSAS) and healthcare personnel with regard to informational needs, side-effects and their consequences on adherence. MethodsA cross-sectional descriptive design was used including 350 CPAP treated OSAS patients from three Swedish hospitals and 105 healthcare personnel from 26 Swedish hospitals. Data collection was performed using two questionnaires covering informational needs, side-effects and adherence to CPAP. ResultsBoth groups perceived all surveyed informational areas as very important. Patients perceived the possibilities to learn as significantly greater in all areas (p < 0.001) compared to healthcare personnel, and scored significantly higher regarding positive effects on adherence of information about pathophysiology (p < 0.05), self-care (p < 0.001) and troubleshooting (p < 0.01). A total of 11 out of 15 surveyed side-effects were perceived to be more frequent by healthcare personnel (p < 0.01-p < 0.001). They also scored all side-effects to cause greater problems and decrease the CPAP use to a greater extent (p < 0.001). ConclusionKnowledge about these differences between patients and healthcare personnel regarding educational needs, side-effects and their effects on adherence can be important when designing educational programmes to increase CPAP adherence. Practice implicationsMeasurement of these parameters before, during and after educational programs are suggested.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Perceived informational needs, side-effects and their consequences on adherence—A comparison between CPAP treated patients with OSAS and healthcare personnel

Broström

Strömberg

Ulander

et al. 2009

Patient Education and Counseling

View full text Add to dashboard Cite

show abstract

“…Some other authors were unable to find significant differences between interventions in these types of programmes [47]. It is possible that, in the future, new technologies such as telemedicine will have a key role in these programmes [48,49], contributing to an increase in adherence [50].…”

Section: Group B N=22mentioning

confidence: 99%

Effect of an ambulatory diagnostic and treatment programme in patients with sleep apnoea

Andreu¹,

Chiner²,

Sancho-Chust³

et al. 2011

Eur Respir J

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The aim of this study to evaluate the efficacy of a home-based programme on clinical response, continuous positive airway pressure (CPAP) compliance and cost in a population of high pre-test probability of suffering obstructive sleep apnoea syndrome (OSAS).Patients were randomised into the following three groups. Group A: home respiratory polygraphy (RP) and home follow-up; group B: hospital polysomnography and hospital followup; and group C: home RP and hospital follow-up. Evaluation during 6 months included Epworth Sleepiness Scale (ESS), Functional Outcomes Sleep Questionnaire (FOSQ), and daily activity and symptom questionnaires. Compliance was assessed by memory cards (group A) and using an hourly counter (groups B and C).66 patients were included (22 per branch), 83% were males, aged mean¡SD 52¡10 yrs, body mass index 34¡7kg?m -2 , apnoea/hypopnoea index 43¡20 h -1 , CPAP pressure 8¡2 cmH 2 O, with no between-group differences. Clinical response showed an ESS of mean¡SD 15¡3 to 6¡4, a FOSQ of 16¡3 to 18¡2, symptoms of 43¡7 to 25¡7, and activity of 37¡11 to 25¡8. At the end of the study, compliance was: group A 73%, group B 68% and group C 57%. The cost per patient was: group A J590¡43, group B J894¡11 and group C J644¡93 (p,0.001).In conclusion, patients with a high initial probability of having OSAS can be diagnosed and treated in a home setting, with a high level of CPAP compliance and lower cost than using either a hospital-based approach or home RP/hospital follow-up.

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“…This effect may account for part of the high overall compliance, compared with literature [14] and has already caused difficulties in observing differences in several interventional CPAP trials [18,[22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Compliance in sleep apnoea therapy: influence of home care support and pressure mode

Damjanović¹,

Fluck²,

Bremer³

et al. 2009

Eur Respir J

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Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnoea syndrom (OSAS) but therapy adherence is often low. The hypothesis that CPAPadherence and clinical outcomes can be improved by either using an autoadjusting-CPAP (APAP) device or an intensive support was tested.A controlled parallel group study was performed with 100 newly diagnosed OSAS patients, randomised into 4 groups (n525 each): standard or intensive support plus either APAP or CPAP. Intensive support included education and monthly home visits for 6 months. Clinical outcome was monitored by polysomnography at CPAP initiation and, after 3 and 9 months, compliance data were downloaded from the CPAP devices.After 9 months, intensively supported patients returned for follow-up in 88 versus 68% in the standard-support-group. Daily usage (mean¡SEM 5. In summary, intensive support after continuous positive airway pressure initiation, rather than the application of autoadjusting-continuous positive airway pressure, increased therapy adherence.

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Effects of Augmented Continuous Positive Airway Pressure Education and Support on Compliance and Outcome in a Chinese Population

Cited by 132 publications

References 29 publications

Perceived informational needs, side-effects and their consequences on adherence—A comparison between CPAP treated patients with OSAS and healthcare personnel

Perceived informational needs, side-effects and their consequences on adherence—A comparison between CPAP treated patients with OSAS and healthcare personnel

Effect of an ambulatory diagnostic and treatment programme in patients with sleep apnoea

Compliance in sleep apnoea therapy: influence of home care support and pressure mode

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