None listed
Conditions
Brief summary
This project aims to (1) assess the effectiveness of a coaching intervention (C) in increasing adherence to CPAP compared with an enhanced education or treatment as usual (TAU) intervention; (2) to identify individuals with low self-efficacy scores who are at risk of stopping treatment and (3) to examine the role of mood, quality of life and well-being in the treatment response. The hypothesis is that the C intervention will increase uptake and adherence to CPAP and will improve low baseline self-efficacy scores as individuals feel they can perceive themselves using CPAP effectively. By using CPAP on a nightly basis for most of the night, mood and well-being, sleepiness and sleep related quality of life and self-efficacy will also be improved. A total of 60 individuals diagnosed with OSA will be recruited into the study on the basis of being naive to CPAP treatment and having low self-efficacy scores (<4). Participants will be randomised to either the current treatment as usual group (TAU) which consists of psycho-education and mask fitting (1.5 - 2 hours) before the CPAP titration night or a coaching group (C). The C group will undergo the psycho-education and mask fitting but will also undertake 4 individual coaching sessions at baseline (3 face-to-face session and 1 by telephone). All participants will be asked attend 4 CPAP data usage download sessions and to complete questionnaires at baseline, 1 week after starting CPAP, 1 month after starting CPAP, 12 weeks after starting CPAP and 3 months after study end. All participants will receive a CPAP machine and tubing free of charge for the duration of the study. Past CPAP research has found that self-efficacy predicts CPAP adherence, and as SF/CBC has been found to enhance self-efficacy and goal attainment and adherence, thus advancing knowledge and practice in CPAP and contributing to the broader emerging area of health coaching.
Interventions
Participants will be randomised to either the current Treatment As Usual group (TAU) or a Coaching Group (C). Both TAU and C groups will undergo a psycho-education and mask fitting session (1.5 - 2 hours), a CPAP Titration study night, a 1 hour CPAP set-up session, and 4 CPAP data usage download sessions (each 1 hour in length). In addition, the C group will also receive four, one hour one-to-one coaching sessions – three face-to-face and one by phone.
The psycho-education is a group sessio
Participants will be randomised to either the current Treatment As Usual group (TAU) or a Coaching Group (C). Both TAU and C groups will undergo a psycho-education and mask fitting session (1.5 - 2 hours), a CPAP Titration study night, a 1 hour CPAP set-up session, and 4 CPAP data usage download sessions (each 1 hour in length). In addition, the C group will also receive four, one hour one-to-one coaching sessions – three face-to-face and one by phone. The psycho-education is a group session of a standardised slide presentation containing information about normal sleep, daytime and night-time health consequences of untreated OSA , and the effectiveness of CPAP treatment. Side-effects encountered when using CPAP will be highlighted and discussed. All participants will have a trial of CPAP at a pressure of 4cm H20 in a supine position and will be encouraged to handle the equipment. Participants will also be encouraged to seek help and support for any mechanical difficulties throughout the study period. During the CPAP titration night, subjects will undergo an in-laboratory manual titration of their CPAP pressure with polysomnography (PSG). CPAP-therapy pressure will be titrated to treat apnea, hypopnea, and flow limitation, with a therapy target of AHI<5 per hour of sleep. A prescription for an appropriate CPAP pressure and well sealing mask will be provided for participants. The coaching sessions involve: Coaching Session 1 (immediately after the psycho-education and mask fitting session): to develop a collaborative relationship between coach and participant, help the participant develop personally meaningful coaching goals and explore how CPAP treatment can be incorporated into their lifestyle. Coaching Session 2 (immediately after the CPAP set-up session): This session will review and evaluate actions and progress to date. Participant generated goals will be set and action plans developed. The key focus will be on identifying areas of success thus far and coaching the participant to capitalise on these, although barriers to change will also be explored where relevant. Coaching Sessions 3 & 4: to help the participant prepare for longer-term use of the CPAP equipment, exploring ways to consolidate change and building self-efficacy, confidence and motivation levels. Session 3 will be between the 1st and 2nd download sessions and Session 4 will be immediately after the 3rd download session.
Sponsors
Air Liquide Healthcare
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Any patient (over 18 years) with untreated OSA and a low self-efficacy score (4 or lower)
Exclusion criteria
Previous use of CPAP Individuals not fluent in written and oral English
Outcome results
None listed