title: The efficacy of a brief motivational enhancement education program on CPAP adherence in OSA: a randomized controlled trial.
abstract: BACKGROUND
  Poor adherence to CPAP treatment in OSA adversely affects the effectiveness of this therapy. This randomized controlled trial (RCT) examined the efficacy of a brief motivational enhancement education program in improving adherence to CPAP treatment in subjects with OSA.
  
  
  METHODS
  Subjects with newly diagnosed OSA were recruited into this RCT. The control group received usual advice on the importance of CPAP therapy and its care. The intervention group received usual care plus a brief motivational enhancement education program directed at enhancing the subjects' knowledge, motivation, and self-efficacy to use CPAP through the use of a 25-min video, a 20-min patient-centered interview, and a 10-min telephone follow-up. Self-reported daytime sleepiness adherence-related cognitions and quality of life were assessed at 1 month and 3 months. CPAP usage data were downloaded at the completion of this 3-month study.
  
  
  RESULTS
  One hundred subjects with OSA (mean ± SD, age 52 ± 10 years; Epworth Sleepiness Scales [ESS], 9 ± 5; median [interquartile range] apnea-hypopnea index, 29 [20, 53] events/h) prescribed CPAP treatment were recruited. The intervention group had better CPAP use (higher daily CPAP usage by 2 h/d [Cohen d = 1.33, P < .001], a fourfold increase in the number using CPAP for ≥ 70% of days with ≥ 4 h/d [P < .001]), and greater improvements in daytime sleepiness (ESS) by 2.2 units (P = .001) and treatment self-efficacy by 0.2 units (P = .012) compared with the control group.
  
  
  CONCLUSIONS
  Subjects with OSA who received motivational enhancement education in addition to usual care were more likely to show better adherence to CPAP treatment, with greater improvements in treatment self-efficacy and daytime sleepiness.
  
  
  BACKGROUND
  ClinicalTrials.gov; No.: NCT01173406; URL: www.clinicaltrials.gov.
authors.affiliation: Department of Medicine, The University of Hong Kong, Hong Kong, SAR, China; Queen Mary Hospital, School of Nursing, The University of Hong Kong, Hong Kong, SAR, China.
authors.forename: Agnes Y K
authors.initials: AYK
authors.lastname: Lai
authors.affiliation: Queen Mary Hospital, School of Nursing, The University of Hong Kong, Hong Kong, SAR, China.
authors.forename: Daniel Y T
authors.initials: DYT
authors.lastname: Fong
authors.affiliation: Department of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
authors.forename: Jamie C M
authors.initials: JCM
authors.lastname: Lam
authors.affiliation: College of Nursing, University of Illinois at Chicago, Chicago, IL.
authors.forename: Terri E
authors.initials: TE
authors.lastname: Weaver
authors.affiliation: Department of Medicine, The University of Hong Kong, Hong Kong, SAR, China; Research Centre of Heart, Brain, Hormone, and Healthy Aging, The University of Hong Kong, Hong Kong, SAR, China. Electronic address: msmip@hku.hk.
authors.forename: Mary S M
authors.initials: MSM
authors.lastname: Ip
mesh_terms: D000328:Adult; D045422:Continuous Positive Airway Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D011788:Quality of Life / Q000523:psychology; D057566:Self Report; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D016896:Treatment Outcome; D014743:Videotape Recording