Barriers to treatment of paediatric obstructive sleep apnoea: Development of the adherence barriers to continuous positive airway pressure (CPAP) questionnaire.

Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, USA.
Sleep Medicine (Impact Factor: 3.1). 12/2011; 13(2):172-7. DOI: 10.1016/j.sleep.2011.10.026
Source: PubMed

ABSTRACT Continuous positive airway pressure (CPAP) treatment is often prescribed for youth as a treatment for obstructive sleep apnoea (OSA). Efficacy research in youth is limited, though some evidence suggests that it may relieve symptoms of OSA and possibly prevent future physical, emotional, and behavioural complications. However, the device must be used consistently for benefits to be realised. Non-adherence to medical treatment is prevalent among youth with chronic illness, yet little is known regarding adherence to CPAP in paediatric OSA.
Using a sample of 51 youth (age 8-17 years) recruited from a paediatric sleep specialty clinic, the aims of the current study were to: (1) present descriptive data regarding CPAP adherence in youth with OSA, and (2) develop a psychometrically sound measure of barriers for adherence to CPAP use for youth with OSA.
Results indicated that adherence to CPAP is poor: youth in the current sample used their CPAP on average 3.35 h per night. The adherence barriers measure demonstrated excellent psychometric properties.
The adherence barriers to CPAP questionnaire has the potential to be a useful clinic-based tool for identifying patient-specific issues with CPAP adherence in youth with OSA.

  • Sleep Medicine Clinics 06/2014;
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    ABSTRACT: Adolescents with obstructive sleep apnea syndrome (OSAS) represent an important but understudied subgroup of long-term continuous positive airway pressure (CPAP) users. The purpose of this qualitative study was to identify factors related to adherence from the perspective of adolescents and their caregivers. Individual open-ended, semi-structured interviews were conducted with adolescents (n = 21) and caregivers (n = 20). Objective adherence data from the adolescents' CPAP machines during the previous month was obtained. Adolescents with different adherence levels and their caregivers were asked their views on CPAP. Using a modified grounded theory approach, we identified themes and developed theories that explained the adolescents' adherence patterns. Adolescent participants (n = 21) were aged 12-18 years, predominantly male (n = 15), African American (n = 16), users of CPAP for at least one month. Caregivers were mainly mothers (n = 17). Seven adolescents had high use (mean use 381 ± 80 min per night), 7 had low use (mean use 30 ± 24 min per night), and 7 had no use during the month prior to being interviewed. Degree of structure in the home, social reactions, mode of communication among family members, and perception of benefits were issues that played a role in CPAP adherence. Understanding the adolescent and family experience of using CPAP may be key to increasing adolescent CPAP adherence. As a result of our findings, we speculate that health education, peer support groups, and developmentally appropriate individualized support strategies may be important in promoting adherence. Future studies should examine these theories of CPAP adherence. Prashad PS; Marcus CL; Maggs J; Stettler N; Cornaglia MA; Costa P; Puzino K; Xanthopoulos M; Bradford R; Barg FK. Investigating reasons for CPAP adherence in adolescents: a qualitative approach. J Clin Sleep Med 2013;9(12):1303-1313.
    Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 01/2013; 9(12):1303-13. · 2.93 Impact Factor
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    ABSTRACT: To investigate self-reported barriers to medication adherence among chronically ill adolescents, and to investigate whether barriers are unique to specific chronic diseases or more generic across conditions. A systematic search of Web of Science, PubMed, Embase, PsycINFO, and CINAHL from January 2000 to May 2012 was conducted. Articles were included if they examined barriers to medication intake among chronically ill adolescents aged 13-19 years. Articles were excluded if adolescent's views on barriers to adherence were not separated from younger children's or caregiver's views. Data was analyzed using a thematic synthesis approach. Of 3,655 records 28 articles with both quantitative, qualitative, and q-methodology study designs were included in the review. The synthesis led to the following key themes: Relations, adolescent development, health and illness, forgetfulness, organization, medicine complexity, and financial costs. Most reported barriers to adherence were not unique to specific diseases. Some barriers seem to be specific to adolescence; for example, relations to parents and peers and adolescent development. Knowledge and assessment of barriers to medication adherence is important for both policy-makers and clinicians in planning interventions and communicating with adolescents about their treatment.
    Journal of Adolescent Health 10/2013; · 2.75 Impact Factor


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May 21, 2014