@article{oai:kanazawa-u.repo.nii.ac.jp:00050502,
 author = {加藤, 千夏 and 稲垣, 美智子 and 多崎, 恵子 and Kato, Chinatsu and Inagaki, Michiko and Tasaki, Keiko},
 issue = {2},
 journal = {Journal of wellness and health care, Journal of wellness and health care},
 month = {Feb},
 note = {[Aim] The definition of good adherence to continuous positive airway pressure (CPAP)
therapy for obstructive sleep apnea syndrome (OSA) is a utilization rate of ≥70% and a
mean usage time on usage days of ≥ 4 hours, and users who deviate from this definition
are regarded as having poor adherence. Personalized guidance is required to improve the
adherence of users with poor adherence. Hence, a more detailed classification is needed
rather than simply classifying users as having poor and good adherence. Thus, this study
aimed to clarify the significance of classification of adherence into four groups based on
the two indices of utilization rate (%) and mean usage time (hours).
[Method] This study examined CPAP users at the CPAP specialist outpatient department
from October to November 2016. In total, 535 patients were included, and information
on CPAP adherence, physical data at initial consultation, and data on motivation for
consultation were collected. The survey period was set as 2 months. The CPAP users
were divided into four groups, and a 4-group comparison was conducted on factors that
affect adherence, using the χ ² test, the Kruskal-Wallis test, and the pairwise method.
The utilization rate was set as the vertical axis and the mean usage time on usage days
was set as the horizontal axis to create a scatter plot. The four segments were created by
intersecting the axes with the values of “70%” and “4 hours”, with the top right set as
the good adherence group “≥70%/≥ 4 hours”; moving counterclockwise, the next segments
were set as the insufficient adherence time group “≥70%/<4 hours,” poor adherence group
“≤70%/<4 hours,” and insufficient adherence days group “<70%, ≥ 4 hours.”
[Results] The good adherence group (n=393) accounted for 70% of users; the remaining
30%, conventionally classified together as users with poor adherence, were distributed into
insufficient adherence time group (n=31), poor adherence group (n=49), and insufficient
adherence days group (n=62). No significant differences in sex or residual AHI were
observed, but significant difference was observed in age, usage history, and BMI between
the good adherence group and poor adherence group. The percentage of patients with
hypertension was significantly different between the good adherence group and insufficient
adherence days group. There was a significant difference in the percentage of patients
who sought consultation due to subjective symptoms between the insufficient adherence
days group and insufficient adherence time group. The percentage of patients who sought
consultation due to a recommendation by a company medical checkup showed a significant
difference between the good adherence group and insufficient adherence days group.
[Conclusion] These results suggest that adherence can be divided into four groups based
on utilization rate and mean usage time on usage days, and that these classifications may
be helpful for constructing a guidance management system that emphasizes personalized
guidance systems.},
 pages = {11--22},
 title = {Classification of adherence of CPAP users: a four-group comparison based on utilization rate and mean usage time on usage days},
 volume = {43},
 year = {2020}
}