Núria Nadal1,2, Jordi de Batlle1, Ferran Barbé1,3, Josep Ramon Marsal4, Alicia Sánchez-de-la-Torre1,3, Nuria Tarraubella1,2, Merce Lavega2, Manuel Sánchez-de-la-Torre5,6,7. 1. Hospital Universitari Arnau de Vilanova and Santa Maria. IRBLleida, Lleida, Spain. 2. Primary Care Unit of Lleida, Catalonia, Spain. 3. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. 4. Lleida Research Support Unit, Primary Care Research Institute (IDIAP) Jordi Gol, Catalonia, Spain. 5. Hospital Universitari Arnau de Vilanova and Santa Maria. IRBLleida, Lleida, Spain. sanchezdelatorre@gmail.com. 6. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain. sanchezdelatorre@gmail.com. 7. Hospital Arnau de Vilanova-Santa María, CIBERES, IRBLleida, Avda. Rovira Roure 80, 25198, Lleida, Spain. sanchezdelatorre@gmail.com.
Abstract
BACKGROUND: Good adherence to continuous positive airway pressure (CPAP) treatment improves the patient's quality of life and decreases the risk of cardiovascular disease. Previous studies that have analyzed the adherence to CPAP were performed in a sleep unit (SU) setting. The involvement of primary care (PC) in the management of obstructive sleep apnea (OSA) patients receivingCPAP treatment could introduce factors related to the adherence to treatment. OBJECTIVES: The objective was to compare the baseline predictors of CPAP compliance in SU and PC settings. METHODS:OSA patients treated with CPAP were followed for 6 months in SU or PC setting. We included baseline clinical and anthropometrical variables, the Epworth Sleep Scale (ESS) score, the quality of life index, and the Charlson index. A logistic regression was performed for each group to determine the CPAP compliance predictors. Discrimination and calibration were performed using the area under the curve and Hosmer-Lemeshow tests. RESULTS: We included 191 patients: 91 in the PC group and 100 in the SU group. In 74.9% of the patients, the compliance was ≥ 4 h per day, with 80% compliance in the SU setting and 69.2% compliance in the PC setting (p = 0.087). The predictors of CPAP compliance were different between SU and PC settings. Body mass index, ESS, and CPAP pressure were predictors in the SU setting, and ESS, gender, and waist circumference were predictors in the PC setting. CONCLUSIONS: The predictors of adequate CPAP compliance vary between SU and PC settings. Detecting compliance predictors could help in the planning of early interventions to improve CPAP adherence.
RCT Entities:
BACKGROUND: Good adherence to continuous positive airway pressure (CPAP) treatment improves the patient's quality of life and decreases the risk of cardiovascular disease. Previous studies that have analyzed the adherence to CPAP were performed in a sleep unit (SU) setting. The involvement of primary care (PC) in the management of obstructive sleep apnea (OSA) patients receiving CPAP treatment could introduce factors related to the adherence to treatment. OBJECTIVES: The objective was to compare the baseline predictors of CPAP compliance in SU and PC settings. METHODS: OSA patients treated with CPAP were followed for 6 months in SU or PC setting. We included baseline clinical and anthropometrical variables, the Epworth Sleep Scale (ESS) score, the quality of life index, and the Charlson index. A logistic regression was performed for each group to determine the CPAP compliance predictors. Discrimination and calibration were performed using the area under the curve and Hosmer-Lemeshow tests. RESULTS: We included 191 patients: 91 in the PC group and 100 in the SU group. In 74.9% of the patients, the compliance was ≥ 4 h per day, with 80% compliance in the SU setting and 69.2% compliance in the PC setting (p = 0.087). The predictors of CPAP compliance were different between SU and PC settings. Body mass index, ESS, and CPAP pressure were predictors in the SU setting, and ESS, gender, and waist circumference were predictors in the PC setting. CONCLUSIONS: The predictors of adequate CPAP compliance vary between SU and PC settings. Detecting compliance predictors could help in the planning of early interventions to improve CPAP adherence.
Authors: Amy M Sawyer; Nalaka S Gooneratne; Carole L Marcus; Dafna Ofer; Kathy C Richards; Terri E Weaver Journal: Sleep Med Rev Date: 2011-06-08 Impact factor: 11.609