The Development of a Novel mHealth Tool for Obstructive Sleep Apnea: Tracking Continuous Positive Airway Pressure Adherence as a Percentage of Time in Bed.
The Development of a Novel mHealth Tool for Obstructive Sleep Apnea: Tracking Continuous Positive Airway Pressure Adherence as a Percentage of Time in Bed.
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DOI：
10.2196/39489
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发表时间：
2022-12-05
影响因子：
7.4
通讯作者：
Tasali, Esra
中科院分区：
文献类型：
--
作者：
Pfammatter, Angela Fidler;Hughes, Bonnie Olivia;Tucker, Becky;Whitmore, Harry;Spring, Bonnie;Tasali, Esra
持续正压通气(CPAP)是阻塞性睡眠呼吸暂停(OSA)的主要治疗方法，但对CPAP的依从性较差。目前的指南规定每晚使用4小时的CPAP作为目标，以确定适当的治疗依从性。然而，有效的OSA治疗需要在卧床的整个时间内使用CPAP，以最佳地治疗呼吸事件，并防止与不戴CPAP设备的睡眠时间相关的不良健康影响。每晚的睡眠模式差异很大，因此有必要衡量与卧床时间相关的CPAP依从性。减肥是阻塞性睡眠呼吸暂停综合征患者的重要目标。需要工具来解决阻塞性睡眠呼吸暂停综合征患者的这些临床挑战。这项研究旨在开发一种移动健康工具，将减肥功能与新的CPAP依从性跟踪(即CPAP磨损时间相对于客观评估的卧床时间的百分比)结合起来，用于OSA患者。我们使用迭代的、以用户为中心的流程设计了一个新的CPAP遵守跟踪模块，该模块与现有的减肥应用程序集成在一起。研究对象为37例年龄20~65岁的阻塞性睡眠呼吸暂停综合征患者。在第一阶段，接受CPAP治疗的OSA患者(n=7)测试减肥APP，以跟踪10天的营养、活动和体重。参与者完成了可用性和可接受性调查。在第二阶段，接受CPAP治疗的OSA患者(n=21)完成了一项基于网络的调查，了解他们对CPAP跟踪模块线框的解释和偏好。在第三阶段，9例新近确诊的阻塞性睡眠呼吸暂停患者(n=9)接受CPAP设备(ResMed AirSense10 AutoSet)的治疗，并对集成的APP进行3~4周的测试。参与者完成了可用性调查，并提供了反馈。在第一阶段，参与者发现这款应用程序大部分都很容易使用，除了在搜索特定食物方面有一些困难。所有参与者都认为联网设备(Fitbit活动跟踪器和Fitbit Aria秤)易于使用，也很有帮助。在第二阶段，参与者正确地解释了CPAP坚持的成功率，用佩戴时间相对于卧床时间的百分比表示，并倾向于看到一个明确的百分比目标(目标：100%)。在第三阶段，参与者发现集成的应用程序很容易使用，并要求推送通知提醒睡前佩戴CPAP，并在早上同步Fitbit。我们开发了一个移动健康工具，将新的CPAP遵守跟踪模块集成到现有的减肥应用程序中。新的功能包括解决阻塞性睡眠呼吸暂停综合征和肥胖的共病，通过CPAP佩戴时间相对于客观评估的卧床时间的百分比来跟踪CPAP遵守情况，以及推动通知以促进遵守。关于该工具在改善OSA治疗依从性方面的有效性的未来研究是有必要的。
Continuous positive airway pressure (CPAP) is the mainstay obstructive sleep apnea (OSA) treatment; however, poor adherence to CPAP is common. Current guidelines specify 4 hours of CPAP use per night as a target to define adequate treatment adherence. However, effective OSA treatment requires CPAP use during the entire time spent in bed to optimally treat respiratory events and prevent adverse health effects associated with the time spent sleeping without wearing a CPAP device. Nightly sleep patterns vary considerably, making it necessary to measure CPAP adherence relative to the time spent in bed. Weight loss is an important goal for patients with OSA. Tools are required to address these clinical challenges in patients with OSA. This study aimed to develop a mobile health tool that combined weight loss features with novel CPAP adherence tracking (ie, percentage of CPAP wear time relative to objectively assessed time spent in bed) for patients with OSA. We used an iterative, user-centered process to design a new CPAP adherence tracking module that integrated with an existing weight loss app. A total of 37 patients with OSA aged 20 to 65 years were recruited. In phase 1, patients with OSA who were receiving CPAP treatment (n=7) tested the weight loss app to track nutrition, activity, and weight for 10 days. Participants completed a usability and acceptability survey. In phase 2, patients with OSA who were receiving CPAP treatment (n=21) completed a web-based survey about their interpretations and preferences for wireframes of the CPAP tracking module. In phase 3, patients with recently diagnosed OSA who were CPAP naive (n=9) were prescribed a CPAP device (ResMed AirSense10 AutoSet) and tested the integrated app for 3 to 4 weeks. Participants completed a usability survey and provided feedback. During phase 1, participants found the app to be mostly easy to use, except for some difficulty searching for specific foods. All participants found the connected devices (Fitbit activity tracker and Fitbit Aria scale) easy to use and helpful. During phase 2, participants correctly interpreted CPAP adherence success, expressed as percentage of wear time relative to time spent in bed, and preferred seeing a clearly stated percentage goal (“Goal: 100%”). In phase 3, participants found the integrated app easy to use and requested push notification reminders to wear CPAP before bedtime and to sync Fitbit in the morning. We developed a mobile health tool that integrated a new CPAP adherence tracking module into an existing weight loss app. Novel features included addressing OSA-obesity comorbidity, CPAP adherence tracking via percentage of CPAP wear time relative to objectively assessed time spent in bed, and push notifications to foster adherence. Future research on the effectiveness of this tool in improving OSA treatment adherence is warranted.
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影响因子：
2.2
作者：
Pfammatter, Angela Fidler;Nahum-Shani, Inbal;Spring, Bonnie
通讯作者：
Spring, Bonnie
影响因子：
76.2
作者：
Benjafield, Adam V.;Ayas, Najib T.;Malhotra, Atul
通讯作者：
Malhotra, Atul
影响因子：
8.3
作者：
Billings, Martha E.;Krishnan, Vidya;Thomson, Carey C.
通讯作者：
Thomson, Carey C.
DOI：
10.1513/pats.200707-114mg
发表时间：
2008-02-15
期刊：
Proceedings of the American Thoracic Society
影响因子：
--
作者：
Eckert, Danny J;Malhotra, Atul
通讯作者：
Malhotra, Atul
影响因子：
3.7
作者：
Farao, Jaydon;Malila, Bessie;Douglas, Tania S.
通讯作者：
Douglas, Tania S.