Where to Next for Optimizing Adherence in Large-scale Trials of CPAP?

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obstructive sleep apnea
continuous positive airway pressure
patient compliance
health behavior
telemedicine
health education
controlled clinical trial
behavioral economics
Medicine and Health Sciences
Nursing

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Wallace, Douglas M
Buenaver, Luis F
Watach, Alexa J
Blase, Amy
Saconi, Bruno
Patel, Sanjay R
Kuna, Samuel T
Punjabi, Naresh M

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Abstract

Large-scale randomized trials of positive airway pressure (PAP) efficacy have been largely negative yet PAP adherence was notably sub-optimal across the trials. To address this limitation, evidence-based PAP adherence protocols embedded within the larger trial protocol are recommended. The complexity of such protocols will be dependent on adequacy of resources, including funding and inclusion of behavioral scientist experts on the scientific team, and trial-specific considerations (e.g., target population) and methods. Recommendations for optimizing PAP adherence in large-scale trials are set forth that address rigor and reproducibility.

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2020-05-28

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Optimizing Adherence in Trials Author Deposited Pre-Print Accepted 5.28.20 by Sleep Medicine Clinics (Special Issue: Unraveling the Puzzle of Adherence in Sleep [Ed.] J. Bakker) This work was supported in part by NIH/NIDDK (DK120051, PI Punjabi). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

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