title: Impact of group education on continuous positive airway pressure adherence.
abstract: OBJECTIVE
  To compare the impact of a group educational program versus individual education on continuous positive airway pressure (CPAP) adherence.
  
  
  METHODS
  Post hoc assessment of a performance improvement initiative designed to improve clinic efficiency, access to care, and time to initiate therapy. Consecutive patients newly diagnosed with obstructive sleep apnea (OSA) initiating CPAP therapy participated in either an individual or group educational program. The content and information was similar in both strategies.
  
  
  RESULTS
  Of 2,116 included patients, 1,032 received education regarding OSA and CPAP through a group clinic, and 1,084 received individual education. Among the cohort, 76.6% were men, mean age 48.3 ± 9.2 years, mean body mass index 29.6 ± 4.6 kg/m(2), and mean apnea-hypopnea index was 33.3 ± 24.4 events/hour. Baseline characteristics were similar between groups. CPAP adherence was significantly greater in those participating in a group program than those receiving individual education. Specifically, CPAP was used for more nights (67.2% vs. 62.1%, p = 0.02) and more hours per night during nights used (4.3 ± 2.1 vs. 3.7 ± 2.8, p = 0.03). Further, fewer individuals discontinued therapy (10.6% vs. 14.5%, p < 0.001), more achieved regular use of CPAP (45.2%. vs. 40.6%, p = 0.08), and time to initiate therapy was shorter (13.2 ± 3.1 versus 24.6 ± 7.4 days, p < 0.001). Group education resulted in a 3- to 4-fold increase in the number of patients seen per unit time.
  
  
  CONCLUSIONS
  A group educational program facilitated improved CPAP adherence. If confirmed by prospective randomized studies, group CPAP education may be an appropriate alternative to individual counseling, may improve acceptance of and adherence to therapy, and decrease time to treatment.
authors.affiliation: Pulmonary, Critical Care, and Sleep Medicine, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA. Christopher.Lettieri@us.army.mil
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Lettieri
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Walter
mesh_terms: D045422:Continuous Positive Airway Pressure; D004219:District of Columbia; D005260:Female; D006126:Group Processes; D006801:Humans; D008297:Male; D008875:Middle Aged; D017145:Models, Educational; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D020181:Sleep Apnea, Obstructive / Q000628:therapy*
keywords: CPAP; OSA; adherence; education