Sleep Apnea
Conditions
Keywords
Health coaching, Adherence to treatment, Health disparities
Brief summary
This study will test a brief telephonic health coaching intervention to improve adherence to positive airway pressure therapy for treatment of obstructive sleep apnea.
Detailed description
The investigators will carry out a pilot study in which patients will be randomly assigned to receive health coaching or usual care. Participants are English- and Spanish-speaking patients from a county-based public health system who have received a positive airway pressure device for the treatment of sleep apnea. An unlicensed, trained health coach will call patients three times to resolve barriers to adherence. Primary outcomes include both adherence measures collected by the device modem at baseline and 4 months, and patient-reported outcomes such as daytime sleepiness.
Interventions
BEHAVIORALHealth coaching
Brief telephonic intervention consisting of up to five phone calls from a health coach
Sponsors
University of California, San Francisco
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
Patients are randomly assigned to receive health coaching or usual care. Patients assigned to usual care have access to all existing 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. Patients in the health coaching arm have access to all usual care resources. In addition, they will be assigned an unlicensed, trained health coach who will call them up to five 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.
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 * Not currently meeting Medicare standards for adherence of at least 4 hours per night for at least 70% of the last 30 nights * 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 |
|---|---|---|
| Mean number of hours used on average over the last 30 days | Enrollment to 4 months post enrollment | Total number of hours PAP device used during 30 day period divided by 30 days (PAP device is part of existing clinical care) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion using device at any time in last 30 days | Enrollment to 4 months post enrollment | Numerator: Number of people using PAP device at any time in last 30 days; Denominator: Number of people in study arm (PAP device is part of existing clinical care) |
| Patient-reported daytime sleepiness | Enrollment to 4 months post enrollment | Mean score on the Epworth Sleepiness Scale (8 items with aggregate scale of 0-24 points, where 24 indicates greatest sleepiness symptoms) |
| Attitudes to PAP treatment | Enrollment to 4 months post enrollment | Mean score on the Attitudes to PAP Treatment Inventory (5 items with combined scale of 4-25, where higher scores indicate negative attitudes toward PAP treatment) |
| Confidence in using PAP therapy | Enrollment to 4 months post enrollment | Mean score on self-efficacy for use of PAP therapy (4 items, with combined scale from 0-40, where 40 indicates greatest self-efficacy) |
| Mean number of hours used on average over the last 30 days on nights that device was used | Enrollment to 4 months 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 4 months post enrollment | Mean across group of: (Numerator: Number of days in last 30 days that PAP device was used at least 4 hours; Denominator: 30 days) (PAP device is part of existing clinical care) |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORRachel Willard-Grace, MPH
University of California, San Francisco
Outcome results
None listed