Impact of Healthcare Non-Take-Up on Adherence to Long-Term Positive Airway Pressure Therapy
Najeh Daabek
(1, 2)
,
Renaud Tamisier
(1, 3)
,
Alison Foote
(3)
,
Hélèna Revil
(4)
,
Marie Joyeux-Jaure
(1, 2, 3)
,
Jean-Louis Pépin
(1, 3)
,
Sébastien Bailly
(1, 3)
,
Jean-Christian Borel
(1, 2)
Najeh Daabek
- Function: Author
- PersonId: 803567
- ORCID: 0000-0002-3092-4752
Renaud Tamisier
- Function: Author
- PersonId: 782606
- IdHAL: renaud-tamisier
- ORCID: 0000-0003-1128-6529
- IdRef: 054059747
Jean-Louis Pépin
- Function: Author
- PersonId: 760683
- ORCID: 0000-0003-3832-2358
- IdRef: 110689410
Sébastien Bailly
- Function: Author
- PersonId: 748589
- IdHAL: sebastien-bailly
- ORCID: 0000-0002-2179-4650
- IdRef: 189027290
Jean-Christian Borel
- Function: Author
- PersonId: 862979
- ORCID: 0000-0003-4140-6210
- IdRef: 137449801
Abstract
Background: The effectiveness of positive airway pressure therapies (PAP) is contingent on treatment adherence. We hypothesized that forgoing healthcare may be a determinant of adherence to PAP therapy. Research Question: The objectives were: (i) to assess the impact of forgoing healthcare on adherence to PAP in patients with Chronic Respiratory Failure (CRF) and patients with Obstructive Sleep Apnea Syndrome (OSAS); (ii) to compare forgoing healthcare patterns in these two chronic conditions. Study design and methods: Prospective cohort of patients with OSAS or CRF, treated with PAP therapies at home for at least 12 months. At inclusion, patients were asked to fill-in questionnaires investigating (i) healthcare forgone, (ii) deprivation (EPICES score), (iii) socio-professional and familial status. Characteristics at inclusion were extracted from medical records. PAP adherence was collected from the device's built-in time counters. Multivariable logistic regression models were used to assess the associations between healthcare forgone and the risk of being non-adherent to CPAP treatment. Results: Among 298 patients included (294 analyzed); 33.7% reported forgoing healthcare. Deprivation (EPICES score > 30) was independently associated with the risk of non-adherence (OR = 3.57, 95%CI [1.12; 11.37]). Forgoing healthcare had an additional effect on the risk of non-adherence among deprived patients (OR = 7.74, 95%CI [2.59; 23.12]). OSAS patients mainly forwent healthcare for financial reasons (49% vs. 12.5% in CRF group), whereas CRF patients forwent healthcare due to lack of mobility (25%, vs. 5.9 % in OSAS group). Interpretation: Forgoing healthcare contributes to the risk of PAP non-adherence particularly among deprived patients. Measures tailored to tackle forgoing healthcare may improve the overall quality of care in PAP therapies. Clinical Trial Registration: The study protocol was registered in ClinicalTrials.gov , identifier: NCT03591250.
Domains
Humanities and Social SciencesSubmission Type | Notice |
---|---|
Deposit type | Journal articles |
Title |
en
Impact of Healthcare Non-Take-Up on Adherence to Long-Term Positive Airway Pressure Therapy
|
Abstract |
en
Background: The effectiveness of positive airway pressure therapies (PAP) is contingent on treatment adherence. We hypothesized that forgoing healthcare may be a determinant of adherence to PAP therapy. Research Question: The objectives were: (i) to assess the impact of forgoing healthcare on adherence to PAP in patients with Chronic Respiratory Failure (CRF) and patients with Obstructive Sleep Apnea Syndrome (OSAS); (ii) to compare forgoing healthcare patterns in these two chronic conditions. Study design and methods: Prospective cohort of patients with OSAS or CRF, treated with PAP therapies at home for at least 12 months. At inclusion, patients were asked to fill-in questionnaires investigating (i) healthcare forgone, (ii) deprivation (EPICES score), (iii) socio-professional and familial status. Characteristics at inclusion were extracted from medical records. PAP adherence was collected from the device's built-in time counters. Multivariable logistic regression models were used to assess the associations between healthcare forgone and the risk of being non-adherent to CPAP treatment. Results: Among 298 patients included (294 analyzed); 33.7% reported forgoing healthcare. Deprivation (EPICES score > 30) was independently associated with the risk of non-adherence (OR = 3.57, 95%CI [1.12; 11.37]). Forgoing healthcare had an additional effect on the risk of non-adherence among deprived patients (OR = 7.74, 95%CI [2.59; 23.12]). OSAS patients mainly forwent healthcare for financial reasons (49% vs. 12.5% in CRF group), whereas CRF patients forwent healthcare due to lack of mobility (25%, vs. 5.9 % in OSAS group). Interpretation: Forgoing healthcare contributes to the risk of PAP non-adherence particularly among deprived patients. Measures tailored to tackle forgoing healthcare may improve the overall quality of care in PAP therapies. Clinical Trial Registration: The study protocol was registered in ClinicalTrials.gov , identifier: NCT03591250.
|
Authors |
Najeh Daabek
1, 2
, Renaud Tamisier
1, 3
, Alison Foote
3
, Hélèna Revil
4
, Marie Joyeux-Jaure
1, 2, 3
, Jean-Louis Pépin
1, 3
, Sébastien Bailly
1, 3
, Jean-Christian Borel
1, 2
1
HP2 -
Hypoxie et PhysioPathologie
( 1079233 )
- Facultés de médecine et de pharmacie Domaine de la merci 38706 LA TRONCHE CEDEX
- France
2
Agir à dom.
( 100299 )
- 36, chemin du Vieux Chêne, 38240 Meylan
- France
3
CHUGA -
Centre Hospitalier Universitaire [CHU Grenoble]
( 257328 )
- CS 10217
38043 Grenoble cedex 9
- France
4
PACTE -
Pacte, Laboratoire de sciences sociales
( 1043180 )
- Siège : IEP - BP 48 38040 Grenoble cedex 9
- France
|
Fulltext language |
English
|
Journal |
|
Science popularization |
No
|
Peer-reviewed |
Yes
|
Audience |
International
|
Publication date |
2021-08-17
|
Volume |
9
|
ANR project(s) |
|
Domain |
|
DOI | 10.3389/fpubh.2021.713313 |
PubMed Central | PMC8416102 |
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