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东南亚一家私立医疗保健系统中阻塞性睡眠呼吸暂停(OSA)患者对持续气道正压通气治疗的接受度和依从性

Acceptance and Adherence to Continuous Positive Airway Pressure Therapy in patients with Obstructive Sleep Apnea (OSA) in a Southeast Asian privately funded healthcare system.

作者信息

Lee Cheah Hooi Ken, Leow Leong Chai, Song Pei Rong, Li HuiHua, Ong Thun How

机构信息

Singapore General Hospital, Respiratory and Critical Care Medicine - Singapore - Singapore - Singapura.

Singapore General Hospital, Health Services Research - Singapore - Singapore - Singapura.

出版信息

Sleep Sci. 2017 Apr-Jun;10(2):57-63. doi: 10.5935/1984-0063.20170010.

Abstract

BACKGROUND

There is limited data on long term Continuous Positive Airway Pressure (CPAP) adherence in Southeast Asian countries. This is a prospective study on CPAP adherence among Obstructive sleep apnea (OSA) patients in a Southeast Asian privately funded healthcare system.

METHODS

Patients with moderate-severe OSA who had been initiated on CPAP at least one year previously were contacted for a scripted telephone interview to assess compliance and factors associated with CPAP adherence.

RESULTS

Of 135 consecutive patients diagnosed to have moderate to severe OSA, 78 (57.8%) were initiated on CPAP treatment while 57 (42.2%) rejected CPAP upfront. 41 (52.6%) who initiated CPAP remained adherent at one year. OSA severity (AHI, ODI) and symptomatic improvement after CPAP were associated with better adherence. Presence of machine related side effects was associated with lower adherence. Inconvenience, cost and poor disease perception were reported as major barriers to uptake of CPAP therapy.

CONCLUSIONS

In this Southeast Asian privately funded healthcare system, almost half of all patients with significant OSA rejected CPAP treatment upfront, but adherence among those who started CPAP is comparable to other reports. Challenges with CPAP acceptance as well as CPAP adherence need to be addressed to improve outcomes.

摘要

背景

东南亚国家关于长期持续气道正压通气(CPAP)依从性的数据有限。这是一项针对东南亚一家私立医疗保健系统中阻塞性睡眠呼吸暂停(OSA)患者CPAP依从性的前瞻性研究。

方法

联系至少在一年前开始使用CPAP的中重度OSA患者,进行有脚本的电话访谈,以评估依从性以及与CPAP依从性相关的因素。

结果

在135例连续诊断为中重度OSA的患者中,78例(57.8%)开始接受CPAP治疗,而57例(42.2%)一开始就拒绝使用CPAP。开始使用CPAP的患者中有41例(52.6%)在一年后仍保持依从性。OSA严重程度(呼吸暂停低通气指数、氧减指数)以及CPAP治疗后的症状改善与更好的依从性相关。机器相关副作用的存在与较低的依从性相关。不方便、成本和对疾病的认知不足被报告为接受CPAP治疗的主要障碍。

结论

在这个东南亚私立医疗保健系统中,几乎一半的中重度OSA患者一开始就拒绝CPAP治疗,但开始使用CPAP的患者的依从性与其他报告相当。需要解决CPAP接受度和CPAP依从性方面的挑战,以改善治疗效果。

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