Improving Adherence and Quality of Life of CPAP for Obstructive Sleep Apnea With An Intervention Based On Stratification and Personalization of Care Plans: A Randomized Controlled Trial (original) (raw)

2021, Research Square (Research Square)

The aim was to determine adherence to CPAP and health-related outcomes in patients with OSA via a comprehensive program based on strati cation and individualized care plans, including motivational interview. Methods A multicentre, randomized controlled trial (RCT) design was used in 3 hospitals. The control group followed the usual treatment. Intervention group (PIMA) followed the treatment with an adapted care plan (home visits, telephone, care-center) depending on socio-demographic, clinical and psychological variables, using motivational interviews in all the interventions. The main outcome was adherence, and secondary were quality of life, emotional state, activities, social relationships, perceived competence, and motivation. The clinical trial was registered with www.clinicaltrials.gov (NCT 04691479). Results 213 patients (68.1% men, 58.7% between 51-69 years old, 45.5% upper-secondary school education) were randomized: 108 were in the intervention group and 105 were in the control group. The result showed a statistically signi cant difference in adherence at 90 and 180 days respectively: 129.24 (IC 95% 77.25-181.22) p < 0.0001 and 288.30 (IC95% 187.146-389.47) p < 0.0001. The adherence (hours/day) showed favourable results for the PIMA group compared to the control group at 90 days with a difference of 1.74 hours/day (IC95% 1.18-2.30) p < 0.0001 and at 180 days with a difference of 2.31 (IC95% 1.72-2.91) p < 0.001. The results for secondary outcomes also showed statistically signi cant differences in favour of the PIMA group. Conclusions This study found evidence that a program based on strati cation and personalized care plans, through motivational interviewing, improves adherence to CPAP treatment and health-related outcomes than traditional care.