Watach Alexa J, Hwang Dennis, Sawyer Amy M
Division of Sleep Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
Patient Prefer Adherence. 2021 Jul 12;15:1557-1570. doi: 10.2147/PPA.S264927. eCollection 2021.
Obstructive sleep apnea (OSA), a common sleep disorder characterized by repeated pauses in breathing during sleep, is effectively treated with positive airway pressure (PAP) therapy. The magnitude of improvements in daily functioning and reduced negative health risks are dependent on maintaining PAP adherence, which is a significant challenge. Evidence-based interventions to improve PAP use are not easily translated to clinical practice because they are labor-intensive and require specialty expertise. Further, to date, individualized care, inclusive of personalized medicine and patient- and person-centered care have been marginally incorporated in the field's understanding of OSA and PAP adherence. This integrative review describes current PAP adherence assessment processes, interventions to improve adherence, and outlines future opportunities to advance the field, particularly as it relates to individualizing care and the use of implementation science to apply evidence to practice.
阻塞性睡眠呼吸暂停(OSA)是一种常见的睡眠障碍,其特征是睡眠期间呼吸反复暂停,采用气道正压通气(PAP)疗法可有效治疗。日常功能改善的程度以及负面健康风险的降低取决于保持对PAP的依从性,而这是一项重大挑战。改善PAP使用情况的循证干预措施不易转化为临床实践,因为它们需要耗费大量人力且需要专业知识。此外,迄今为止,包括个性化医疗以及以患者和人为中心的护理在内的个性化护理在该领域对OSA和PAP依从性的认识中仅得到了有限的纳入。本整合性综述描述了当前PAP依从性评估流程、改善依从性的干预措施,并概述了该领域未来的发展机遇,特别是在个性化护理以及运用实施科学将证据应用于实践方面。