Where to Next for Optimizing Adherence in Large-Scale Trials of Continuous Positive Airway Pressure?

Amy M. Sawyer; Douglas M. Wallace; Luis F. Buenaver; Alexa J. Watach; Amy Blase; Bruno Saconi; Sanjay R. Patel; Samuel T. Kuna; Naresh M. Punjabi

doi:10.1016/j.jsmc.2020.10.007

Where to Next for Optimizing Adherence in Large-Scale Trials of Continuous Positive Airway Pressure?

Amy M. Sawyer, Douglas M. Wallace, Luis F. Buenaver, Alexa J. Watach, Amy Blase, Bruno Saconi, Sanjay R. Patel, Samuel T. Kuna, Naresh M. Punjabi

School of Medicine

Research output: Contribution to journal › Review article › peer-review

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.

Original language	English (US)
Pages (from-to)	125-144
Number of pages	20
Journal	Sleep Medicine Clinics
Volume	16
Issue number	1
DOIs	https://doi.org/10.1016/j.jsmc.2020.10.007
State	Published - Mar 2021

Keywords

Behavioral economics
Continuous positive airway pressure
Controlled clinical trial
Health behavior
Health education
Obstructive sleep apnea
Patient compliance
Telemedicine

ASJC Scopus subject areas

Neuropsychology and Physiological Psychology
Clinical Psychology
Clinical Neurology
Psychiatry and Mental health

Access to Document

10.1016/j.jsmc.2020.10.007

Cite this

@article{e5b44086e4c24ef9aea12f2f7a485af4,

title = "Where to Next for Optimizing Adherence in Large-Scale Trials of Continuous Positive Airway Pressure?",

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.",

keywords = "Behavioral economics, Continuous positive airway pressure, Controlled clinical trial, Health behavior, Health education, Obstructive sleep apnea, Patient compliance, Telemedicine",

author = "Sawyer, {Amy M.} and Wallace, {Douglas M.} and Buenaver, {Luis F.} and Watach, {Alexa J.} and Amy Blase and Bruno Saconi and Patel, {Sanjay R.} and Kuna, {Samuel T.} and Punjabi, {Naresh M.}",

note = "Funding Information: Dr A.M. Sawyer has received grant support from NIH, American Nurses Foundation , American Lung Association , and VA HSR&D . Dr D.M. Wallace has no disclosures. Dr L.F. Buenaver discloses grant support from NIH and American Sleep Medicine Foundation . Ms A. Blase is an employee of ResMed Corp. Dr A.J. Watach discloses research training support from NIH (HL07953). Mr B. Saconi has no disclosures. Dr S.R. Patel discloses grant support from NIH (DK120051) and has received grant support from NIH, Bayer Pharmaceuticals , Philips Respironics , and Respicardia . Dr S.T. Kuna discloses grant support from NIH (DK120051). Dr N.M. Punjabi discloses grant support from NIH (NL117167, HL146709, DK120051) and from ResMed and Philips Respironics to Johns Hopkins University. Funding Information: This work was supported in part by NIH /NIDDK (DK120051, principal investigator N.M. Punjabi). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the US government. Publisher Copyright: {\textcopyright} 2020",

year = "2021",

month = mar,

doi = "10.1016/j.jsmc.2020.10.007",

language = "English (US)",

volume = "16",

pages = "125--144",

journal = "Sleep Medicine Clinics",

issn = "1556-407X",