Adherence to continuous positive airway pressure treatment for obstructive sleep apnoea: implications for future interventions.
Adherence to continuous positive airway pressure treatment for obstructive sleep apnoea: implications for future interventions.
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发表时间：
2010-02
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通讯作者：
T. Weaver;A. Sawyer
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作者：
T. Weaver;A. Sawyer
持续气道正压通气（CPAP）治疗阻塞性睡眠呼吸暂停（OSA）是一个关键问题。CPAP依从性差（30-60%）被广泛认为是治疗OSA的一个重要限制因素，降低了治疗的整体有效性，并使许多OSA患者面临合并症、功能受损和生活质量受损的高风险。现存的研究CPAP依从性的文献为测量依从性结果、定义最佳依从性水平和预测CPAP依从性提供了重要的见解。这项研究揭示了与CPAP依从性相关或预测CPAP依从性的显著因素，并可能指导干预措施的发展，以促进CPAP依从性。在过去的10年里，促进CPAP依从性的干预研究已经纳入了多种策略，包括教育，支持，认知行为方法和混合策略。这篇关于CPAP依从性研究现状的综述将（i）综合现有文献中关于测量、定义和预测CPAP依从性的内容;（ii）回顾已发表的旨在促进CPAP依从性的干预研究;（iii）为将来CPAP依从性的经验性研究提出方向，这将对转化科学产生影响。我们目前对CPAP依从性的理解表明，依从性是一个多因素的复杂临床问题，需要类似设计的方法来有效解决OSA人群中CPAP依从性差的问题。
Adherence to continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) is a critical problem. Poor adherence (30-60%) to CPAP is widely recognized as a significant limiting factor in treating OSA, reducing the overall effectiveness of the treatment and leaving many OSA patients at heightened risk for co-morbid conditions, impaired function and quality of life. The extant literature examining adherence to CPAP provides critical insight to measuring adherence outcomes, defining optimal adherence levels, and predicting CPAP adherence. This research has revealed salient factors that are associated with or predict CPAP adherence and may guide the development of interventions to promote CPAP adherence. Over the past 10 years, intervention studies to promote CPAP adherence have incorporated a multitude of strategies including education, support, cognitive behavioural approaches, and mixed strategies. This review of the current status of research on CPAP adherence will (i) synthesize the extant literature with regard to measuring, defining, and predicting CPAP adherence; (ii) review published intervention studies aimed at promoting CPAP adherence; and (iii) suggest directions for future empiric study of adherence to CPAP that will have implications for translational science. Our current understanding of CPAP adherence suggests that adherence is a multi-factorial, complex clinical problem that requires similarly designed approaches to effectively address poor CPAP adherence in the OSA population.