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Where to Next for Optimizing Adherence in Large-Scale Trials of Continuous Positive Airway Pressure?
Amy M Sawyer1, Douglas M Wallace2, Luis F Buenaver3
1Department of Biobehavioral Health Science, University of Pennsylvania School of Nursing, 418 Curie Boulevard, Claire Fagin Hall, Room 349, Philadelphia, PA 19104, USA; Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA; University of Pennsylvania Perelman School of Medicine, Center for Sleep and Circadian Neurobiology, Philadelphia, PA, USA.
Abstract:
Large-scale randomized trials of positive airway pressure (PAP) efficacy have been largely negative but PAP adherence was notably suboptimal 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 depends on adequacy of resources, including funding and inclusion of behavioral scientist experts on the scientific team, and trial-specific considerations (eg, 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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