机构：[1]Department of RespiratoryMedicine, The 2nd Affiliated Hospitalof Kunming Medical University,Kunming, Yunnan Province, People’sRepublic of C hina[2]Departmentof Epidemiology and Biostatistics,School of Public Health, KunmingMedical University, Kunming, YunnanProvince, People’s Republic of China[3]Epidemiology Unit, Faculty ofMedicine, Prince of Songkla University,Hat Yai, Songkhla, Thailand
To identify patterns of adherence to nasal continuous positive airway pressure (nCPAP) use in the first 3 months of therapy among newly diagnosed adult patients with obstructive sleep apnea/hypopnea syndrome (OSAS) and their predictors. To develop pretherapy and in-therapy scores to predict adherence pattern.Newly diagnosed adult OSAS patients were consecutively recruited from March to August 2013. Baseline clinical information and measures such as Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Zung's Self-Rating Depression Scale (SDS), and The Pittsburgh Sleep Quality Index (PSQI) at baseline and at the end of 3rd-week therapy were collected. Twelve weeks' adherence data were collected from the nCPAP memory card, and K-means cluster analysis was used to explore adherence patterns. Predictive scores were developed from the coefficients of cumulative logit models of adherence patterns using variables available at baseline and after 3 weeks of therapy. Performance of the score was validated using 500 bootstrap resamples.Seventy six patients completed a 12-week follow-up. Three patterns were revealed. Patients were identified as developing an adherence pattern that was poor (n=14, mean ± SD, 2.3±0.9 hours per night), moderate (n=19, 5.3±0.6 hours per night), or good (n=43, 6.8±0.3 hours per night). Cumulative logit regression models (good → moderate → poor) revealed independent baseline predictors to be ESS (per unit increase) (OR [95% CI], 0.763 [0.651, 0.893]), SDS (1.461 [1.238, 1.724]), and PSQI (2.261 [1.427, 3.584]); and 3-week therapy predictors to be ESS (0.554 [0.331, 0.926]), PSQI (2.548 [1.454, 4.465]), and the changes (3rd week-baseline data) in ESS (0.459 [0.243, 0.868]), FSS (3.556 [1.788, 7.070]), and PSQI (2.937 [1.273, 6.773]). Two predictive score formulas for poor adherence were developed. The area under the curve (AUC) of the receiver operating characteristics (ROC) curves for baseline and 3-week formulas were 0.989 and 0.999, respectively. Bootstrap analysis indicated positive predictive values of baseline and 3-week predictive scores in our patient population of 0.82 (95% CI [0.82, 0.83]) and 0.94 (95% CI [0.93, 0.94]), respectively.A high level of prediction of poor adherence pattern is possible both before and at the first 3 weeks of therapy. The predictive scores should be further evaluated for external validity.
基金：
Yunnan Provincial Science
and Technology Department (2011CZ048) and the National
Natural Science Foundation of China (81460017).
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2015]版：
大类|4 区医学
小类|4 区医学：内科
最新[2023]版：
大类|3 区医学
小类|3 区医学：内科
第一作者：
第一作者机构：[1]Department of RespiratoryMedicine, The 2nd Affiliated Hospitalof Kunming Medical University,Kunming, Yunnan Province, People’sRepublic of C hina[2]Departmentof Epidemiology and Biostatistics,School of Public Health, KunmingMedical University, Kunming, YunnanProvince, People’s Republic of China
通讯作者：
通讯机构：[1]Department of RespiratoryMedicine, The 2nd Affiliated Hospitalof Kunming Medical University,Kunming, Yunnan Province, People’sRepublic of C hina[*1]Department of Respiratory Medicine, The 2nd Affiliated Hospital of Kunming Medical University, No 374, Dianmian Road, Kunming 650101, Yunnan Province, People’s Republic of China
推荐引用方式(GB/T 7714)：
Yeying Wang,Alan F Geater,Yanling Chai,et al.Pre- and in-therapy predictive score models of adult OSAS patients with poor adherence pattern on nCPAP therapy[J].Patient preference and adherence.2015,9:715-23.doi:10.2147/PPA.S83105.
APA：
Yeying Wang,Alan F Geater,Yanling Chai,Jiahong Luo,Xiaoqun Niu...&Yongxia Li.(2015).Pre- and in-therapy predictive score models of adult OSAS patients with poor adherence pattern on nCPAP therapy.Patient preference and adherence,9,
MLA：
Yeying Wang,et al."Pre- and in-therapy predictive score models of adult OSAS patients with poor adherence pattern on nCPAP therapy".Patient preference and adherence 9.(2015):715-23
