Motivational Enhancement for Increasing Adherence to CPAP

Bakker, Jessie P.; Wang, Rui; Weng, Jia; Aloia, Mark S.; Toth, Claudia; Morrical, Michael G.; Gleason, Kevin J.; Rueschman, Michael; Dorsey, Cynthia; Patel, Sanjay R.; Ware, James H.; Mittleman, Murray A.; Redline, Susan

doi:10.1016/j.chest.2016.03.019

Cited by 113Obstructive Sleep Apnea ResearchSleep and related disordersMedication Adherence and Compliance

Motivational Enhancement for Increasing Adherence to CPAP

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Bakker, Jessie P., Wang, Rui, Weng, Jia, Aloia, Mark S., Toth, Claudia, Morrical, Michael G., Gleason, Kevin J., Rueschman, Michael +5 more·2016·CHEST

DOI 10.1016/j.chest.2016.03.019PMC PMC4980541

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Abstract

Background Motivational enhancement (ME) shows promise as a means of increasing adherence to CPAP for OSA.Methods We performed an open-label, parallel-arm, randomized controlled trial of CPAP only or CPAP + ME, recruiting individuals 45 to 75 years with moderate or severe OSA without marked sleepiness and with either established cardiovascular disease (CVD) or at risk for CVD. All participants received standardized CPAP support from a sleep technologist; those randomly assigned to CPAP + ME also received standardized ME delivered by a psychologist during two appointments and six phone calls over 32 weeks. Mixed-effect models with subject-specific intercepts and slopes were fitted to compare objective CPAP adherence between arms, adjusting for follow-up duration, randomization factors, and device manufacturer. All analyses were intention-to-treat.Results Overall, 83 participants (n = 42 CPAP only; n = 41 CPAP + ME) contributed 14,273 nights of data for 6 months. Participants were predominantly male (67%) and had a mean ± SD age of 63.9 ± 7.4 years, a BMI of 31.1 ± 5.2 kg/m(2), and an apnea-hypopnea index of 26.2 ± 12.9 events/h. In our fully adjusted model, average nightly adherence for 6 months was 99.0 min/night higher with CPAP + ME compared with CPAP only (P = .003; primary analysis). A subset of 52 participants remained in the study for 12 months; modeling these data yielded a consistent difference in adherence between arms of 97 min/night (P = .006) favoring CPAP + ME.Conclusions ME delivered during brief appointments and phone calls resulted in a clinically significant increase in CPAP adherence. This strategy may represent a feasible approach for optimizing management of OSA.Trial registry ClinicalTrials.gov; No.: NCT01261390; URL: www.clinicaltrials.gov.

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Bakker et al. found that motivational enhancement via two 1-hour in-person sessions plus phone calls and an educational video resulted in significantly improved average nightly adherence of 99 minutes per night within the treatment group at 12 months.
“A study by Bakker et al. utilized motivational enhancement via two 1-h in-person sessions, in addition to phone calls and an educational video. This intervention resulted in a significantly improved average nightly adherence (99 min/night) within the treatment group at 12 months.1152”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [1152]
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Authors: Bakker, J. P., Wang, R., Weng, J., Aloia, M. S., Toth, C., Morrical, M. G., Gleason, K. J., Rueschman, M., Dorsey, C., Patel, S. R., Ware, J. H., Mittleman, M. A., & Redline, S.
Affiliations: Brigham and Women's Hospital (US)
National Jewish Health (US)
Harvard University (US)
Beth Israel Deaconess Medical Center (US)
Corresponding author: Bakker, Jessie P.
ORCID: Bakker, Jessie P.
Wang, Rui
Weng, Jia
Aloia, Mark S.
Gleason, Kevin J.
Rueschman, Michael
Dorsey, Cynthia
Patel, Sanjay R.
Mittleman, Murray A.
Redline, Susan
Venue: CHEST
Publisher: Elsevier BV
Published: 2016-08
Volume: 150
Issue: 2
Pages: 337-345
ISSN: 0012-3692 (ISSN-L)
DOI: 10.1016/j.chest.2016.03.019
PMC: PMC4980541
OpenAlex: W2308397515
Semantic Scholar: 4eb1b4f2c447a76c15a00593302d4979007f2396
Cited by: 113
References: 28
Citations by year: 2026: 7 · 2025: 7 · 2024: 12 · 2023: 7 · 2022: 19 · 2021: 15 · 2020: 13 · 2019: 13 · 2018: 4 · 2017: 13 · 2016: 3
FWCI: 8.86
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: CHEST Journal (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: ResMed Foundation
National Heart, Lung, and Blood Institute (1U34HL105277)
Topics: Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Keywords: motivation enhancement, CPAP adherence, obstructive sleep apnea, behavioral interventions, telephone counseling, cardiovascular disease, sleep apnea management
MeSH terms: Aged, Cardiovascular Diseases, Female, Humans, Male, Middle Aged, Patient Compliance, Severity of Illness Index, Comorbidity, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure, Intention to Treat Analysis, Motivational Interviewing

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Motivational Enhancement for Increasing Adherence to CPAP

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