Sleep Apnea
Conditions
Brief summary
This study tested a low-resource, brief telephonic health coaching intervention to improve adherence to positive airway pressure therapy for treatment of sleep apnea.
Detailed description
We conducted post hoc analysis of a quality improvement initiative in which patients were randomly assigned to receive health coaching or usual care. Participants were English- and Spanish-speaking patients from a county-based public health system who had previously received a positive airway pressure device for the treatment of sleep apnea. An unlicensed, trained health coach called patients three times to resolve barriers to adherence. Adherence measures collected by device modem at baseline and 4 weeks were the primary outcome measures.
Interventions
BEHAVIORALHealth coaching
Brief telephonic intervention consisting of up to three phone calls
Sponsors
University of California, San Francisco
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Patients were randomly assigned to receive health coaching or usual care. For the health coaching arm, an unlicensed, trained health coach called patients three times to identify and resolve barriers to adherence, including lack of understanding of their condition or the treatment, discomfort in acclimating to treatment, technical difficulties in mask fit or device settings, and challenges in navigating durable medical equipment providers. Patients assigned to usual care had access to all other available resources, including technical support from durable medical equipment providers, respiratory therapist visits with the Sleep Clinic, group visits, or visits with their primary care provider.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* English- or Spanish-speaking * At least 18 years of age * Had previously received a modem-enabled positive airway pressure device for the treatment of sleep apnea * Received care from the San Francisco General Hospital Sleep Clinic
Exclusion criteria
* Not English- or Spanish-speaking * Younger than 18 years * Does not have phone number at which could be reached
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion using device at any time in last 30 days | Enrollment to 30 days post enrollment | Numerator: Number of people using device at any time in last 30 days; Denominator: Number of people in study arm |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mean number of hours used on average over the last 30 days | Enrollment to 30 days post enrollment | Total number of hours device used during 30 day period divided by 30 days |
| Mean number of hours used on average over the last 30 days on nights that device was used | Enrollment to 30 days post enrollment | Total number of hours device used during 30 day period divided by the number of days on which the device was used |
| Mean proportion of last 30 days in which device used at least 4 hours/night | Enrollment to 30 days post enrollment | Mean across group of: (Numerator: Number of days in last 30 days that device was used at least 4 hours; Denominator: 30 days) |
| Proportion meeting Medicare standard for adherence (at least 4 hours/night for at least 70% of last 30 days) | Enrollment to 30 days post enrollment | Numerator: Number of people meeting Medicare standard for adherence; Denominator: Number of people in study arm |
Countries
United States
Outcome results
None listed