Risk Assessment and Tailored Intervention to Improve CPAP Adherence

CPAP依从性差是OSA患者的一个重要问题，导致健康状况不佳， 功能性成果。虽然数量很少，但测试了改善CPAP的干预措施的研究 在选定的样品中，粘附显示出相对较小的影响，并且成本较高。没有发表的研究， 日期特别关注那些不遵守CPAP的高风险人群，或应用定制的 促进持续气道正压通气依从性的干预策略。拟议研究的总体目标是 检查OSA患者CPAP依从性的定制干预的效果、可行性和可接受性 有CPAP不依从风险的患者。该研究将招募高风险CPAP非依从者， 在一项初步随机对照试验中，参与者被随机分配到一个定制的 干预或常规护理（对照）。开发商开发的定制干预措施基于以下原则： 社会认知理论，重点是加强患者教育，CPAP技能培养，促进早期 CPAP的积极经验，建立早期准确和个性化的OSA认知感知 和持续气道正压通气，并纳入就近的社会支持资源。核心假设是， 针对个人的社会文化方面和认知观念的专门干预措施 OSA的诊断和治疗经验将提高那些可能 证明治疗效果不佳具体目的是：（1）确定一个 在OSA患者中，针对CPAP依从性结果在1周、1个月和3个月时的定制干预， 确定预治疗，作为后续不依从的高风险;和（2）确定可行性， 定制干预的可接受性，这将指导后续R 01的干预改进 应用程序.这些初步数据将支持设计和成功进行一项更大规模的随机 对照试验测试定制干预的总体有效性。

Poor adherence to CPAP is a significant problem among OSA patients resulting in suboptimal health and functional outcomes. Although few in number, studies that have tested interventions to improve CPAP adherence have shown relatively small effects in selected samples and were costly. No published studies to date have specifically focused on those persons at high risk for nonadherence to CPAP or applied a tailored inten/ention strategy to promote CPAP adherence. The overall objective of the proposed research is to examine the effect, feasibility, and acceptability of a tailored intervention on CPAP adherence among OSA patients at risk for CPAP nonadherence. The proposed study will enroll high risk CPAP nonadherers, identified pre-treatment, in a pilot randomized control trial with participants randomly assigned to a tailored intervention or usual care (control). The investigator-developed tailored intervention is based on tenets of Social Cognitive Theory and focuses on enhanced patient education, CPAP skill-building, promotion of early positive experiences with CPAP, establishing early accurate and personalized cognitive perceptions of OSA and CPAP, and inclusion of proximate social support resources. The central hypothesis is that critically timed tailored interventions that focus on sociocultural aspects and cognitive perceptions of the individual experience with OSA diagnosis and treatment will improve overall CPAP adherence rates among those likely to demonstrate suboptimal use of the treatment. The specific aims are: (1) to determine the effect size of a tailored intervention on CPAP adherence outcomes at 1 week, 1 month, and 3 months among OSA patients, identified pre-treatment, as high risk for subsequent nonadherence; and (2) to determine the feasibility and acceptability of the tailored intervention which will guide intervention refinement for a subsequent R01 application. These preliminary data will support the design and successful conduct of a larger randomized controlled trial testing the overall effectiveness of the tailored intervention.