title: Patient-Reported Usability of Positive Airway Pressure Equipment Is Associated With Adherence in Older Adults.
abstract: To examine the usability of positive airway pressure (PAP) devices and its association with PAP adherence among older adults with sleep-disordered breathing.
  
  
  
  We mailed questionnaires to patients aged ≥65 years prescribed PAP therapy during the prior 36 months from two large healthcare systems. Survey participants completed the Usability of Sleep Apnea Equipment-Positive Airway Pressure (USE-PAP) questionnaire, which assessed the usability of their PAP device. Other questionnaire items included demographics and self-rated health. We also abstracted adherence data (mean nightly hours of PAP use available from one site) and interface type from the electronic health record.
  
  
  
  Five hundred sixty-four patients completed the survey (response rate = 33%). The mean USE-PAP score (0 = best to 100 = worst) was 20 (SD ± 20). Mean duration of PAP use (available in 189 respondents) was 5.2 hours per night (SD ± 2.0). In a nested regression model predicting nightly hours of PAP use, a 10-point (0.5 SD) increase in USE-PAP score corresponded to a 0.37 hour/night reduction in PAP use. The model including the USE-PAP score explained a significant proportion (R2 = 15%) of the variation in nightly hours of PAP use above and beyond demographics, self-reported health, and interface type (∆R2 = 12%).
  
  
  
  Our results demonstrate that PAP usability varies among older patients and is associated with PAP adherence, above and beyond other predictors of adherence. These results support measuring and improving PAP usability to further improve PAP adherence for older patients.
authors.affiliation: Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Constance H
authors.initials: CH
authors.lastname: Fung
authors.affiliation: Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Martin
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Ron D
authors.initials: RD
authors.lastname: Hays
authors.affiliation: School of Health and Rehabilitation Sciences, Ohio State University, Columbus, Ohio.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Patterson
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Ravi
authors.initials: R
authors.lastname: Aysola
authors.affiliation: University of New England, Biddeford, Maine.
authors.forename: Nananda
authors.initials: N
authors.lastname: Col
authors.affiliation: Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Mitchell
authors.affiliation: Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Cindy
authors.initials: C
authors.lastname: Truong
authors.affiliation: Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Dzierzewski
authors.affiliation: Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Stella
authors.initials: S
authors.lastname: Jouldjian
authors.affiliation: Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Yeonsu
authors.initials: Y
authors.lastname: Song
authors.affiliation: Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.|Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Rodriguez
authors.affiliation: Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California.
authors.forename: Karen
authors.initials: K
authors.lastname: Josephson
authors.affiliation: Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California.|Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Cathy
authors.initials: C
authors.lastname: Alessi
mesh_terms: D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000295:instrumentation / Q000379:methods*; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012648:Self Care; D057566:Self Report; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000628:therapy*; D011795:Surveys and Questionnaires
keywords: adherence; predictive modeling.; sleep apnea; usability