Educational video to improve CPAP use in patients with obstructive sleep apnoea at risk for poor adherence: a randomised controlled trial
Open accessAbstract
BACKGROUND: Suboptimal adherence to CPAP limits its clinical effectiveness in patients with obstructive sleep apnoea (OSA). Although rigorous behavioural interventions improve CPAP adherence, their labour-intensive nature has limited widespread implementation. Moreover, these interventions have not been tested in patients at risk of poor CPAP adherence. Our objective was to determine whether an educational video will improve CPAP adherence in patients at risk of poor CPAP adherence. METHODS: Patients referred by clinicians without sleep medicine expertise to an urban sleep laboratory that serves predominantly minority population were randomised to view an educational video about OSA and CPAP therapy before the polysomnogram, or to usual care. The primary outcome was CPAP adherence during the first 30 days of therapy. Secondary outcomes were show rates to sleep clinic (attended appointment) and 30-day CPAP adherence after the sleep clinic visit date. RESULTS: A total of 212 patients met the eligibility criteria and were randomised to video education (n=99) or to usual care (n=113). There were no differences in CPAP adherence at 30 days (3.3, 95% CI 2.8 to 3.8 hours/day video education; vs 3.5, 95% CI 3.1 to 4.0 hours/day usual care; p=0.44) or during the 30 days after sleep clinic visit. Sleep clinic show rate was 54% in the video education group and 59% in the usual care group (p=0.41). CPAP adherence, however, significantly worsened in patients who did not show up to the sleep clinic. CONCLUSIONS: In patients at risk for poor CPAP adherence, an educational video did not improve CPAP adherence or show rates to sleep clinic compared with usual care. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT02553694.
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Overall, there were 7 RCTs identified that compared a pure educational intervention versus usual care, 6 RCTs that compared a behavioral intervention versus usual care, and 9 RCTs that compared a troubleshooting with education intervention versus usual care.
“Overall, there were 7 RCTs 207,214,215,220,221,229,230 identified that compared a pure educational intervention versus usual care, 6 RCTs 214-219 that compared a behavioral intervention versus usual care, and 9 RCTs 207,220,222-228 that compared a troubleshooting with education intervention versus usual care.”
A meta-analysis of 3 RCTs demonstrated that the mean estimate of the impact of an education intervention on obtaining PAP usage > 4 h/night was clinically significant, with an odds ratio of 1.2 (95% CI: 0.8 to 1.9).
“A meta-analysis of 3 RCTs 214,221,229 demonstrated that the mean estimate of the impact of an education intervention on obtaining PAP usage > 4 h/night was clinically significant, with an odds ratio of 1.2 (95% CI: 0.8 to 1.9)”
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Patil, S. P., Ayappa, I. A., Caples, S. M., Kimoff, R. J., Patel, S. R., & Harrod, C. G. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7638 · Cited by 721 · see citing works
- Authors
- Guralnick, A. S., Balachandran, J. S., Szutenbach, S., Adley, K., Emami, L., Mohammadi, M., Farnan, J. M., Arora, V. M., & Mokhlesi, B.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Mokhlesi, Babak
- Venue
- Thorax
- Publisher
- BMJ
- Published
- 2017-06-30
- Volume
- 72
- Issue
- 12
- Pages
- 1132-1139
- ISSN
- 0040-6376 (ISSN-L)
- 1468-3296
- OpenAlex
- W2727534703
- Semantic Scholar
- fc36173317eaf402059c82c5a6aba2c522a60012
- Cited by
- 36
- References
- 41
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 7 · 2020: 5 · 2019: 8 · 2018: 2
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Thorax (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- University of Chicago
- National Institutes of Health
- Pritzker School of Medicine
- National Heart, Lung, and Blood Institute (R25HL116372, R01HL119161)
- 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
- obstructive sleep apnea, CPAP adherence, CPAP therapy, educational videos, patient education, minority groups
- MeSH terms
- Ambulatory Care Facilities, Chicago, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Patient Compliance, Patient Education as Topic, Video Recording, Single-Blind Method, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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