Background and objectiveAlthough positive screening for and treatment of obstructive sleep apnea (OSA) have been recommended for patients with cardiovascular problems, patient adherence to nasal continuous positive airway pressure (CPAP) therapy primarily for a cardiovascular concern is unknown. Therefore, this study aimed to determine the adherence to CPAP therapy by hypertensive patients with OSA after a screening test performed regardless of OSA-related symptoms.Subjects and methodsCPAP therapy was administered to 194 of the 1365 hypertensive patients who underwent the screening. The monthly dropout from CPAP therapy and the adequate use level (4 h every night, 70% days in a month) were assessed using the Kaplan–Meier analysis over a 3-year follow-up period.ResultsOf the patients, 106 (55%) refused or abandoned the therapy by the end of the follow-up period (adherence, 45%). An adequate use level was maintained by 76 patients (39%). Most of the patients’ background characteristics, including age, sex, Epworth sleepiness scale scores, and parameters obtained on polysomnography, were not related to adherence or adequate use level. The good-compliance level on the first visit after CPAP therapy introduction was most strongly related to adherence (95% CI, 0.05–0.32; p < 0.001) and adequate use level (95% CI, 0.06–0.33; p < 0.05). Fourth quartile of apnea hypopnea index value (greater than 67/h) was also related to adherence (95% CI, 0.21–0.98; p < 0.02) and adequate use level (95% CI, 0.19–0.88; p < 0.05).ConclusionsThe adherence and use level in this population may not be satisfactory but are comparable with those in previous sleep center reports treating symptomatic OSA patients. Thus, the present results would encourage hypertensive patients to undergo positive screening for OSA, regardless of OSA-related symptoms. However, an outcomes study with the same cohort is needed. 相似文献
to verify the face validity, criterion-related validity and the reliability
of two distinct forms of presentation of the instrument Measurement of
Adherence to Treatment, one being for ascertaining the adherence to the use
of oral antidiabetics and the other for adherence to the use of insulin, as
well as to assess differences in adherence between these two modes of drug
therapy.
Method
a methodological study undertaken with 90 adults with Type 2 Diabetes
Mellitus. The criterion-related validity was verified using the Receiver
Operating Characteristic curves; and for the reliability, the researchers
calculated the Cronbach alpha coefficient, the item-total correlation, and
the Pearson correlation coefficient.
Results
the oral antidiabetics and the other showed sensitivity of 0.84, specificity
of 0.35 and a Cronbach correlation coefficient of 0.84. For the adherence to
the use of insulin, the values found were, respectively, 0.60, 0.21 and
0.68. A statistically significant difference was found between the final
scores of the two forms of the instrument, indicating greater adherence to
the use of insulin than to oral antidiabetics.
Conclusion
it is concluded that the two forms of the Measurement of Adherence to
Treatment instrument are reliable and should be used to evaluate adherence
to drug treatment among people with diabetes mellitus. 相似文献
To assess the effectiveness of mandibular advancement devices (MADs) for the treatment of obstructive sleep apnea syndrome (OSAS) over a long-term follow-up in patients non-compliant with continuous positive airway pressure (CPAP) and to identify potential predictive factors of response to MADs.
Methods:
Fifteen OSAS patients were enrolled. Apnea-hypopnea index (AHI) and daytime sleepiness were assessed at baseline and at the end of follow-up. Potential baseline predictors of treatment effectiveness were assessed.
Results:
AHI and Epworth Sleepiness Scale (ESS) scores improved significantly with MADs. Sixty per cent of patients were ‘responders’, of whom 33% were ‘full responders’. Sixty-seven per cent of patients showed total compliance. No correlations between the potential predictors and the response to MAD therapy were found.
Discussion:
Effectiveness of MAD therapy was shown over a long-term follow-up in OSAS patients with low compliance to CPAP. Efforts to identify predictive success factors fell short. 相似文献
ObjectiveThe purpose of this study is to identify personality types that can influence breast cancer screening (BCS) compliance among Korean women with breast cancer using a mixed-method approach. MethodsThe participants consisted of 93 women who underwent surgery for breast cancer between July 2010 and March 2012. The demographic and medical characteristics of the participants were evaluated through structured interviews. To identify personality types, in-depth interviews were performed and the transcribed interviews were evaluated using interpretive phenomenological analysis. The participants were categorized into two groups (compliance and non-compliance) based on compliance with the Korean Breast Cancer Society recommendations for BCS. ResultsFive personality types were identified through phenomenological analysis. There were significant differences in the chi-square test results for the BCS compliance and non-compliance groups according to age (p=0.048), cancer stage (p<0.001), and personality types (p=0.018). Logistic regression showed that the odds ratio for compliance with BCS was 9.35 (p=0.01) for individuals with a cautious-organized personality type, 9.38 (p=0.02) for those with a cautious-dependent personality, and 10.58 (p=0.04) for those with a sensitive-downcast personality compared to those with a cautious personality type. ConclusionParticipants with cautious-organized, cautious-dependent, and sensitive-downcast personality types were less likely to follow the BCS recommendations than those with a cautious personality type. This study provides a basis for the future development of an effective questionnaire to investigate the personality types of individuals with breast cancer in order to predict compliance with BCS. 相似文献