Simon Stacey L, Stephenson Judith J, Haynes Kevin, Kennedy Elaine Rose, Frydman Gilles, Amdur Adam, Parthasarathy Sairam
University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Carelon Research, Wilmington, Delaware.
J Clin Sleep Med. 2024 Mar 1;20(3):407-416. doi: 10.5664/jcsm.10890.
Although treatment of obstructive sleep apnea (OSA) with positive airway pressure (PAP) therapy is effective, adherence is often poor. Understanding the patient perspective is needed to inform adherence-promoting interventions. This qualitative study assessed the experiences, preferences, facilitators, and barriers surrounding PAP therapy for the management of OSA in patients from adolescence to older adulthood.
Eligible participants ages 19 and older were identified from administrative health care claims; adolescent participants ages 12-18 and their parents/caregivers were identified via electronic health records of a tertiary sleep specialty clinic at a large children's hospital. Forty English-speaking patients and 10 parents of adolescents diagnosed with OSA and prescribed PAP therapy completed semistructured 60-minute telephone interviews conducted by a trained facilitator. Common themes and illustrative quotes were identified.
Themes around OSA diagnosis, initiating OSA treatment, learning about OSA/PAP, decision to start PAP, PAP benefits and challenges, and reasons for nonadherence were identified. Participants suggested design and delivery changes to improve PAP devices. Issues unique to adolescents and their parents were discussed.
The unique perspectives of patients regarding PAP therapy should be taken into consideration when developing interventions to increase PAP adherence and improve clinical care. Based on identified themes, opportunities for intervention may exist at all stages of care, from diagnosis to treatment initiation. Involving partners, parents, and other caregivers in PAP therapy may be beneficial for optimizing adherence.
Simon SL, Stephenson JJ, Haynes K, et al. The lived experience of positive airway pressure therapy in patients with obstructive sleep apnea across the lifespan: a qualitative study. . 2024;20(3):407-416.
尽管使用气道正压通气（PAP）疗法治疗阻塞性睡眠呼吸暂停（OSA）是有效的，但依从性往往较差。需要了解患者的观点，以便为促进依从性的干预措施提供依据。这项定性研究评估了从青少年到老年患者使用PAP疗法治疗OSA的经历、偏好、促进因素和障碍。
从行政医疗保健索赔中确定年龄在19岁及以上的符合条件的参与者；通过一家大型儿童医院三级睡眠专科诊所的电子健康记录确定12 - 18岁的青少年参与者及其父母/照顾者。40名讲英语且被诊断为OSA并接受PAP疗法的患者以及10名青少年的父母完成了由一名经过培训的主持人进行的60分钟半结构化电话访谈。确定了常见主题和说明性引述。
确定了围绕OSA诊断、开始OSA治疗、了解OSA/PAP、决定开始使用PAP、PAP的益处和挑战以及不依从原因等主题。参与者建议对PAP设备进行设计和交付方面的改进。讨论了青少年及其父母特有的问题。
在制定提高PAP依从性和改善临床护理的干预措施时，应考虑患者对PAP疗法的独特观点。根据确定的主题，从诊断到治疗开始的所有护理阶段都可能存在干预机会。让伴侣、父母和其他照顾者参与PAP治疗可能有助于优化依从性。
Simon SL, Stephenson JJ, Haynes K, et al. The lived experience of positive airway pressure therapy in patients with obstructive sleep apnea across the lifespan: a qualitative study.. 2024;20(3):407 - 416.
