Improving continuous positive airway pressure adherence among adults

Abstract

Study objectives: Continuous positive airway pressure (CPAP) is the gold standard of treatment for patients diagnosed with significant obstructive sleep apnea (OSA).  It has been estimated that approximately 30%-50% of patients diagnosed with OSA reject CPAP immediately and 80% of patients prescribed CPAP are noncompliant within a year after starting CPAP therapy. Nonadherence with CPAP greatly reduces the overall effectiveness of treatment of OSA, leaving these patients at an increased risk for comorbid conditions, impaired daily functioning and decreased quality of life. The purpose of this study was to improve CPAP adherence by implementing an intervention that consisted of an education program and increased patient support options as well as increased provider education.

Methods: This study was a quasi-experimental study design.  CPAP adherence rates on 660 patients at an academic sleep center in New York City were collected, 326 patients at baseline and 334 post-intervention. Interventions, included provider education on OSA and CPAP adherence; an improved and actively supported, individualized, patient education program; and additional individual and group patient support options were available for patients.

Results: Increased provider education, individualized intense patient education and patient support options increased CPAP adherence by 21%.  Increase in adherence between baseline and post-intervention group was statistically significant (p = .005).

Conclusions: A targeted program of increased patient education and intensive patient support was effective at increasing CPAP adherence. The use of similar approaches may improve CPAP adherence in other centers. It is crucial to improve CPAP adherence among patients diagnosed with significant OSA in order to improve outcomes.