Cognitive Behavioral Therapy to Increase CPAP Adherence in Veterans with PTSD

认知行为疗法可提高患有 PTSD 的退伍军人对 CPAP 的依从性

• 批准号: 9085019
• 负责人: Lisa M. Kinoshita
• 金额: --
• 依托单位: VETERANS ADMIN PALO ALTO HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2020-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9085019
• 关键词: Address; Adherence; Aging; American; Analysis of Covariance; Appointment; Arts; Auditory; Award; Caring; Chronic; Clinical; Clinical Research; Clinical Trials; Cognition; Cognitive; Cognitive Therapy; Comorbidity; Complex; Continuous Positive Airway Pressure; Data; Data Analyses; Data Set; Databases; Dementia; Deterioration; Development; Diagnosis; Diagnostic and Statistical Manual of Mental Disorders; Doctor of Philosophy; Elderly; Environment; Epidemiologic Studies; Epidemiology; Evidence based practice; Exposure to; Fostering; Gender; Goals; Health; Healthcare Systems; Hour; Hypoxemia; Impaired cognition; Individual; Individual Differences; Intervention; Lead; Left; Longevity; Lung; Masks; Measures; Mediating; Mediator of activation protein; Medical; Medicine; Memory; Moods; Myocardial Infarction; Obesity; Obstructive Sleep Apnea; Outcome; Participant; Patient Self-Report; Patients; Physicians; Post-Traumatic Stress Disorders; Protocols documentation; Provider; Psychiatrist; Psychologist; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Recurrence; Rehabilitation Research; Rehabilitation therapy; Reporting; Research; Research Design; Research Personnel; Resources; Respiratory Therapy; Risk; Risk Factors; Sampling; Scientist; Self Efficacy; Services; Severities; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep Fragmentations; Sleeplessness; Smoking; Source; Specialist; Statistical Data Interpretation; Stroke; Symptoms; Techniques; Testing; Time; Training; Trauma; Verbal Learning; Veterans; Vietnam; Visit; War; Work; arm; behavior change; daily functioning; design; disability; functional disability; functional outcomes; improved; intervention effect; male; middle age; nerve injury; non-compliance; novel; patient oriented; physical conditioning; post intervention; programs; psychologic; public health relevance; research and development; response; screening; software systems; standard of care; treatment adherence; treatment as usual

 DESCRIPTION (provided by applicant): This is an application for a VA Rehabilitation Research and Development (RR&D) Merit Review Award submitted by Lisa M. Kinoshita, Ph.D. Dr. Kinoshita is currently a Staff Clinical Psychologist at the VA Palo Alto Health Care System with a current 6/8ths VA appointment. Dr. Kinoshita is an established clinician- scientist who conducts patient-centered clinical research on PTSD, obstructive sleep apnea (OSA) and cognition. This award will provide Dr. Kinoshita and her research team with the resources necessary to develop a novel cognitive-behavioral therapy intervention for PTSD Veterans with OSA (CBT-OSA) to increase adherence to continuous positive airway pressure (CPAP) treatment, the standard of care for OSA treatment. To accomplish this goal, she has gathered a team that includes seven Co-Investigators: Dr. Jerome Yesavage (a geriatric psychiatrist and renowned expert in cognitive and psychiatric functioning across the lifespan); Dr. Ware Kuschner (a Board Certified Sleep Medicine physician and a specialist in sleep and sleep disordered breathing); Dr. Jon-Erik Holty (a Board Certified Sleep Medicine physician and a specialist in the diagnosis and treatment of OSA); Dr. Clete Kushida (a Board Certified Sleep Medicine physician and an expert in clinical trials related to sleep disorders and a specialist in the diagnosis and treatment of sleep disorders); Dr. Jauhtai Cheng (a Board Certified Sleep Medicine physician and an expert in the diagnosis of OSA); Dr. Joy Taylor (a cognitive psychologist and expert in the trajectory of cognitive decline); and Dr. Leah Friedman (an expert in sleep and aging and CBT interventions for insomnia and memory); and a team of consultants: Dr. Kristine Yaffe (an internationally renowned expert in sleep disorders, PTSD, aging, cognition and epidemiology); Dr. Craig Rosen (a Clinical Psychologist with an expertise in PTSD diagnosis and treatment, including evidence- based practices); Dr. Donn Posner (a Clinical Psychologist with an expertise in CBT for insomnia and other sleep disorders); Dr. Laura Lazzeroni (a biostatistician with expertise in design/analysis of clinical trials, longitudinal data analysis, and missing data analysis); and Art Noda (a data analyst and database manager with extensive background using Statistical Analysis System (SAS) software, database construction and complex statistical analysis). The purpose of this proposal is to test a novel cognitive-behavioral therapy (CBT) intervention to increase CPAP treatment adherence for PTSD Veterans with a new diagnosis of OSA. [A total of 120 Veterans with PTSD and OSA will be randomized to CBT-OSA or to the RT-only arm.] Intervention effects will be examined at time points during and post-intervention throughout the 1-year study. The Primary Aim of this study is to examine the efficacy of CBT-OSA in increasing the average hours per night of CPAP use. Dr. Kinoshita will also use advanced statistical techniques to evaluate the impact of the CBT-OSA intervention on: daily functioning, mood and quality of life (Specific Aim 2); cognition (Specific Aim 3); and PTSD symptoms (Specific Aim 4) in Veterans with PTSD. This award will create an ideal environment where Dr. Kinoshita and her research team can establish the necessary efficacy data for this novel CBT-OSA treatment. If the intervention is successful, the CBT-OSA treatment may be disseminated to providers within VHA through VA's Evidence-Based Practices (EBP) national roll-out program.