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Review
. 2021 Mar;16(1):125-144.
doi: 10.1016/j.jsmc.2020.10.007. Epub 2020 Dec 15.

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

Amy M Sawyer  1 , Douglas M Wallace  2 , Luis F Buenaver  3 , Alexa J Watach  4 , Amy Blase  5 , Bruno Saconi  6 , Sanjay R Patel  7 , Samuel T Kuna  8 , Naresh M Punjabi  9
Affiliations
Review

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

Amy M Sawyer et al. Sleep Med Clin. 2021 Mar.

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.

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Conflict of interest statement

Disclosure 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.

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