Improving Continuous Positive Airway Pressure Adherence in patients with Obstructive Sleep Apnea: Impact of Patient and Family Engagement 

Nazia Naz S. Khan, MD, MS  

A randomized control parallel group clinical trial study to assess the impact of patient and family engagement in improving continuous positive airway pressure (CPAP) adherence in patients with obstructive sleep apnea (OSA).  The primary aim of this study is to assess the impact of shared decision-making, patient activation, family engagement on CPAP adherence and satisfaction with decision. 

Untreated OSA is associated with impaired daytime performance, increased risk of traffic accidents, and is an independent risk factor for cardiovascular diseases; associated with significant morbidity and mortality. Despite evidence supporting the benefits of CPAP (cornerstone therapy), improved access to treatment and major improvements in CPAP machine and mask technology, patient adherence to CPAP remains a challenge (only 30 to 58 % as reported by various studies). Patients who are engaged in their health care have a better clinical outcome and have lower costs of care. This patient-centered intervention would provide preliminary data to support development of a large-scale intervention and implementation of such programs to increase patient adherence to CPAP and improve outcomes.  Unlike other studies, the Improving CPAP Adherence Program will use an integrated, multidimensional approach based on the Social ecological perspective theory and the Relational Coordination model; focusing on patient and family education, peer coaching and telephone reminders to increase CPAP adherence. 

Future Funding: will be applied for NIH R21 grant titled, “Advancing Interventions to Improve Medication Adherence (R21)”, program announcement number (PA-14-335) to conduct a large-scale study aimed at assessing the utility of the ICAP in OSA patients and evaluating outcomes.