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社会因素对睡眠呼吸暂停综合征患者持续气道正压通气治疗依从性的影响:一项跨学科、前瞻性观察研究方案。

Sociological determinants of adherence to continuous positive airway pressure in the management of sleep apnoea syndrome: protocol for a transdisciplinary, prospective observational study.

机构信息

HP2 Laboratory, INSERM U1300, Grenoble Alpes University, Grenoble Alpes University Hospital, Grenoble, France

Research Department, Grenoble Alpes University Hospital Northern Site, Grenoble, France.

出版信息

BMJ Open. 2024 Mar 5;14(3):e079765. doi: 10.1136/bmjopen-2023-079765.

Abstract

INTRODUCTION

Obstructive sleep apnoea syndrome (OSAS) is a chronic multiorgan pathology that has a negative impact on quality of life. Continuous positive airway pressure (CPAP) is the first-line treatment for OSAS. However, CPAP termination rates remain very high, and adherence to therapy is a major issue. To date, studies targeting predictive factors of CPAP adherence by OSAS patients mainly include clinical data. The social, socioeconomic, psychological, and home environment aspects have been far less studied and largely underestimated. This study aims to obtain solid quantitative results examining the relationship between the determinants of refusal, non-adherence, or termination of CPAP treatment, and in particular the pivotal role played by health literacy.

METHODS AND ANALYSIS

This is a prospective, multicentre, observational study recruiting patients attending the sleep clinic of the Grenoble Alpes University Hospital, France. Consecutive adults (>18 years) recently diagnosed with OSAS and prescribed CPAP treatment with telemonitoring will be enrolled in the present study. They will benefit from home visits by a CPAP technician or nurse at CPAP initiation. Patients will then be followed up for 6 months through the telemonitoring platform of a home-care provider. The primary objective is to evaluate the impact of health literacy (health literacy, measured by the European Health Literacy Survey questionnaire (HLS-EU-16) on the refusal, non-adherence or termination of CPAP treatment in newly diagnosed OSAS patients, during the first 6 months after diagnosis. The target sample size is 250 participants.

ETHICS AND DISSEMINATION

The study protocol, patient information, and the non-opposition form were approved by the French national ethics committee (CPP 2021-92, January 2022). All patients are required to have signed a written informed consent form permitting their anonymised personal and medical data to be used for clinical research purposes. We will publish the results in a peer-reviewed medical journal and on our institutional websites.

TRIAL REGISTRATION NUMBER

NCT05385302.

摘要

简介

阻塞性睡眠呼吸暂停综合征(OSAS)是一种慢性多器官疾病,对生活质量有负面影响。持续气道正压通气(CPAP)是 OSAS 的一线治疗方法。然而,CPAP 终止率仍然很高,治疗依从性是一个主要问题。迄今为止,针对 OSAS 患者 CPAP 依从性预测因素的研究主要包括临床数据。社会、社会经济、心理和家庭环境方面的研究要少得多,而且在很大程度上被低估了。本研究旨在通过 OSAS 患者拒绝、不依从或终止 CPAP 治疗的决定因素,获得关于 CPAP 治疗的关系的可靠定量结果,特别是健康素养的关键作用。

方法和分析

这是一项前瞻性、多中心、观察性研究,招募了法国格勒诺布尔阿尔卑斯大学医院睡眠诊所的患者。连续的成年人(>18 岁)最近被诊断为 OSAS 并被处方 CPAP 治疗和远程监测,将被纳入本研究。他们将在 CPAP 启动时受益于 CPAP 技术人员或护士的家访。然后,患者将通过家庭护理提供者的远程监测平台在 6 个月内进行随访。主要目的是评估健康素养(通过欧洲健康素养调查问卷(HLS-EU-16)测量)对新诊断的 OSAS 患者在诊断后 6 个月内拒绝、不依从或终止 CPAP 治疗的影响。目标样本量为 250 名参与者。

伦理和传播

研究方案、患者信息和非反对表格已获得法国国家伦理委员会的批准(CPP 2021-92,2022 年 1 月)。所有患者都必须签署一份书面知情同意书,允许使用他们的匿名个人和医疗数据进行临床研究目的。我们将在同行评议的医学期刊和我们的机构网站上发表研究结果。

注册号

NCT05385302。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abe3/10916145/c0ce6cb950cd/bmjopen-2023-079765f01.jpg

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