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Adherence to positive airway pressure therapy
1Biobehavioral and Health Science Division, School of Nursing, Center for Sleep and Respiratory Neurobiology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6096, USA. tew@nursing.upenn.edu
Current Opinion in Pulmonary Medicine
|October 21, 2006
Summary
Improving adherence to continuous positive airway pressure (CPAP) treatment is crucial. Factors like patient characteristics, mask type, and supportive interventions significantly impact CPAP use.
Area of Science:
- Sleep Medicine
- Respiratory Therapy
Background:
- Continuous positive airway pressure (CPAP) is a cornerstone therapy for sleep apnea.
- Patient adherence to CPAP therapy is essential for treatment efficacy but remains a significant clinical challenge.
Purpose of the Study:
- To review the nature of CPAP adherence.
- To identify methods for measuring adherence.
- To explore factors influencing nonadherence and present interventions to improve CPAP use.
Main Methods:
- Literature review of studies on CPAP adherence.
- Analysis of patient characteristics, device features, and psychological factors.
- Evaluation of various intervention strategies.
Main Results:
- Patient factors (sleepiness, disease severity, nasal resistance, perceived benefit) and device features (heated humidification, flexible pressure) influence adherence.
- Mask interface (nasal vs. full face) and patient coping styles (self-efficacy) impact adherence.
- Interventions like educational videotapes and intensive support (titration, education, home visits) enhance CPAP use.
Conclusions:
- CPAP adherence is a critical clinical issue requiring routine assessment and management.
- Frequent patient contact and problem-solving are key to improving adherence.
- Further research is needed to identify adherence factors and cost-effective interventions.
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