title: Modelling Adherence Behaviour for the Treatment of Obstructive Sleep Apnoea.
abstract: Continuous positive airway pressure therapy (CPAP) is known to be the most efficacious treatment for obstructive sleep apnoea (OSA). Unfortunately, poor adherence behaviour in using CPAP reduces its effectiveness and thereby also limits beneficial outcomes. In this paper, we model the dynamics and patterns of patient adherence behaviour as a basis for designing effective and economical interventions. Specifically, we define patient CPAP usage behaviour as a state and develop Markov models for diverse patient cohorts in order to examine the stochastic dynamics of CPAP usage behaviours. We also examine the impact of behavioural intervention scenarios using a Markov decision process (MDP), and suggest a guideline for designing interventions to improve CPAP adherence behaviour. Behavioural intervention policy that addresses economic aspects of treatment is imperative for translation to clinical practice, particularly in resource-constrained environments that are clinically engaged in the chronic care of OSA.
authors.affiliation: Department of Industrial and Manufacturing Engineering, Pennsylvania State University, yckang@psu.edu , phone: 1-814-865-9861, address: 236 Leonhard Building, University Park, PA 16802, USA.
authors.forename: Yuncheol
authors.initials: Y
authors.lastname: Kang
authors.affiliation: College of Nursing, Pennsylvania State University, ams24@psu.edu , phone: 1-814-863-1020, address: 201 Health & Human Development East, University Park, PA 16802, USA.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Sawyer
authors.affiliation: School of Industrial and Systems Engineering, Georgia Tech, pgriffin@gatech.edu , phone: 1-404.894.2300, address: 755 Ferst Drive, NW, Atlanta, GA 30332.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Griffin
authors.affiliation: Department of Industrial and Manufacturing Engineering, Pennsylvania State University, prabhu@engr.psu.edu , phone: 1-814-863-3212, address: 310 Leonhard Building, University Park, PA 16802, USA.
authors.forename: Vittaldas V
authors.initials: VV
authors.lastname: Prabhu
keywords: Behavioural OR; Markov models; cost-effective interventions; obstructive sleep apnoea; treatment adherence behaviour