2024-12-04 アリゾナ大学
A new University of Arizona Health Sciences study found that peer support helps people with sleep apnea use CPAP machines to relieve sleep apnea symptoms. Photo by grandriver via Getty Images
<関連情報>
- https://news.arizona.edu/news/peer-support-could-help-millions-sleep-apnea-slumber-easier-study-finds
- https://www.atsjournals.org/doi/abs/10.1164/rccm.202309-1594OC
閉塞性睡眠時無呼吸症候群のケア調整とアドヒアランス促進のためのピア主導型介入: 無作為化並行群間臨床試験 Peer-Driven Intervention for Care Coordination and Adherence Promotion for Obstructive Sleep Apnea: A Randomized, Parallel-Group Clinical Trial
Sairam Parthasarathy , Christopher Wendel , Michael A. Grandner , Patricia L Haynes , Stefano Guerra , Daniel Combs , and Stuart F Quan
American Journal of Respiratory and Critical Care Medicine Accepted: October 22, 2024
DOI:https://doi.org/10.1164/rccm.202309-1594OC
Abstract
Rationale: Obstructive sleep apnea (OSA) is a common condition that is usually treated by continuous positive airway pressure (CPAP) therapy, but poor adherence is common and is associated with worse patient outcomes and experiences. Patient satisfaction is increasingly adopted as a quality indicator by healthcare systems. Objective: We tested the hypothesis that peer-driven intervention effected through interactive voice-response(PDI-IVR) system leads to better patient satisfaction (primary outcome), care-coordination, and CPAP adherence when compared to active-control. Methods: We performed a 6-month randomized, parallel-group, controlled trial with CPAP naïve patients recruited from four centers and CPAP-adherent patients who were trained to be mentors delivering support through an IVR system. Measurements and Results: In 263 patients, intention-to-treat analysis global satisfaction for sleep-specific services was better in the intervention group (4.57+0.71 Likert scale score) than in the active-control group (4.10+1.13; P<0.001). CPAP adherence was greater in intervention group (4.5+0.2 hours/night; 62.0+3.0% of nights >4 hours usage) versus active-control group (3.7+0.2 hours/night; 51.4+3.0% of nights >4 hours usage; P=0.014 and P=0.023). When compared to active-control group, Patient Assessment of Chronic Illness Care ratings was moderately increased by an adjusted difference of 0.33+0.12 (P=0.009); Consumer Assessment of Healthcare Provider and Systems ratings was not different (adjusted difference of 0.46+0.26; P=0.076); and Client Perception of Coordination Questionnaire was mildly better in the intervention group (adjusted difference 0.15+0.07; P=0.035). Conclusion: Patient satisfaction with care delivery, CPAP adherence, and care-coordination was improved by peer-driven intervention through an IVR system. New payor policies compensating peer-support may enable implementation of this approach. Clinical trial registration available at www.clinicaltrials.gov, ID: NCT02056002.
