Remote monitoring system to support positive airway pressure therapy in patients with obstructive sleep apnea: a multi-center randomized controlled trial.
Shokoufeh Aalaei, Hamed Tabesh, Hadi Shahraki, Fariborz Rezaeitalab, Mahnaz Amini, Lahya Afsharisaleh, Hadi Asadpour, Saeid Eslami
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引用次数: 0
Abstract
Purpose: To develop and evaluate an intervention tailored to patients' needs to increase the rate of positive airway pressure (PAP) adherence in patients afflicted with obstructive sleep apnea (OSA), who undergo PAP therapy.
Methods: A multi-center, 3 parallel-arm, randomized, controlled trial was conducted. Participants with OSA who undergo a PAP therapy were randomized to one of three groups: control arm (usual care), educational booklet arm, and mobile-based application arm. PAP usage, the percentage of days using the device for more than 4 h, change in knowledge, risk perception, outcome expectancy, self-efficacy, and ESS were assessed before and one month after interventions in the three groups. Also, the application usage data were analyzed.
Results: The result showed the change in average PAP usage, knowledge, risk perception, and self-efficacy in the application group was significantly higher than the control and booklet groups. Also, the change in use for more than 4 h in the application group was significantly higher than the control group. Comparing the actual and patients' self-report PAP use indicated patients' self-report about the use of the device is about 50 min (0.8 h) more than the actual amount of use.
Conclusion: The study results indicated that the improvement of primary and secondary outcomes in adherence to PAP was significantly higher in the application group than in other study groups. Given the increasingly penetrating influence of smartphone-based technologies, it seems that mobile-based applications could potentially be adopted in the population of patients with OSA.
目的：开发并评估一种针对患者需求的干预措施，以提高接受气道正压疗法的阻塞性睡眠呼吸暂停（OSA）患者的气道正压坚持率：方法：进行了一项多中心、3 个平行臂、随机对照试验。接受呼吸机治疗的 OSA 患者被随机分为三组：对照组（常规护理）、教育手册组和移动应用组。在干预前和干预后一个月，对三组患者的呼吸机使用情况、使用设备超过 4 小时的天数百分比、知识变化、风险认知、结果预期、自我效能和 ESS 进行了评估。此外，还分析了应用程序的使用数据：结果表明，应用组在 PAP 平均使用率、知识、风险认知和自我效能感方面的变化明显高于对照组和手册组。此外，应用组使用时间超过 4 小时的变化也明显高于对照组。比较患者实际使用和自我报告的 PAP 使用情况表明，患者自我报告的设备使用时间比实际使用时间多出约 50 分钟（0.8 小时）：研究结果表明，应用组在坚持使用 PAP 方面的主要和次要结果改善率明显高于其他研究组。鉴于智能手机技术的影响力日益渗透，基于手机的应用程序似乎有可能在 OSA 患者群体中得到采用：IRCT2017092236314N1; https://en.irct.ir/trial/27185.
期刊介绍：
The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep.
Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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