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Sleep Med Rev. 2014 Apr;18(2):123-39. doi: 10.1016/j.smrv.2013.03.002. Epub 2013 May 29.

Integrating psychology and medicine in CPAP adherence--new concepts?

Author information

1
Rush University Medical Center, Chicago, IL, USA; NHMRC Centre for The Integrated Research and Understanding of Sleep (CIRUS) Sydney Medical School, University of Sydney, Sydney, Australia. Electronic address: megan_crawford@rush.edu.
2
Nuffield Department of Clinical Neurosciences/Sleep & Circadian Neuroscience Institute, University of Oxford, UK; NHMRC Centre for The Integrated Research and Understanding of Sleep (CIRUS) Sydney Medical School, University of Sydney, Sydney, Australia.
3
Woolcock Institute of Medical Research, Sydney, Australia; NHMRC Centre for The Integrated Research and Understanding of Sleep (CIRUS) Sydney Medical School, University of Sydney, Sydney, Australia.

Abstract

To date, continuous positive airway pressure (CPAP) is the most effective intervention in the treatment of obstructive sleep apnoea, but adherence to this treatment is often less than optimal. A variety of factors and interventions that influence and improve CPAP use have been examined. There is increasing recognition of the multifaceted nature of CPAP adherence: the patient's psychological profile and social environment have been recognised, in addition to the more extensively researched patient's treatment and physiological profile. Understanding how these multiple factors impact on CPAP use in an integrative fashion might provide us with a useful holistic model of CPAP adherence. This concept of integration--a biopsychosocial (BPS) approach to health and illness--has previously been described to understand care provision for various chronic health disorders. This paper proposes an adherence framework, whereby variables integrally affect CPAP use. The BPS model has been considered for nearly 35 years; the presence of poor CPAP adherence was acknowledged in the early 1990s--it is timely to incorporate this approach into our care pathway of CPAP users.

KEYWORDS:

Adherence; Biopsychosocial model; Continuous positive airway pressure; Interaction

PMID:
23725820
DOI:
10.1016/j.smrv.2013.03.002
[Indexed for MEDLINE]

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