Pilot of Brief Health Coaching Intervention to Improve Adherence to Positive Airway Pressure Therapy

摘要

Background: Adherence to positive airway pressure (PAP) therapies is poor, particularly among low-income populationsand racial minorities. This study tested a low-resource, brief telephonic health coaching intervention to improve PAP adherence.Methods: Post hoc analysis of a quality improvement initiative in which English-and Spanish-speaking patients from acounty-based public health system were randomly assigned to receive health coaching or usual care. An unlicensed, trainedhealth coach called patients three times to resolve barriers to adherence. A per-protocol analysis was conducted for adherencemeasures collected by device modem at baseline and 30 days.Results: Of 131 people for whom device data were available, 56 were randomized to health coaching and 75 to usual care.At baseline, 47.3% of patients had used their device at any time in the past 30 days, with a mean of 2 hours of use per night.At 30 days, adjusting for baseline, patients in the coaching arm were more likely than usual care patients to use their device(55.4% vs. 41.3%, p = 0.03), and they increased their use for 0.4 hours over usual care ( p = 0.04).Conclusion: This pilot study suggests that a low-cost intervention could be effective at improving PAP adherence, evenin a population known to have poor adherence and among long-term PAP users with poor adherence. Future research mayexamine whether a higher-touch intervention or one using videoconferencing yields greater improvements. This promisingintervention warrants further study.