Peer-Driven Intervention for Care Coordination and Adherence Promotion for Obstructive Sleep Apnea: A Randomized, Parallel-Group Clinical Trial.

Patient satisfaction is increasingly adopted as a quality indicator by healthcare systems.

患者满意度越来越多地被医疗系统作为质量指标采用。

Objectives: We tested the hypothesis that peer-driven intervention effected through an interactive voice response (IVR) system leads to better patient satisfaction (primary outcome), care coordination, and CPAP adherence than active control.

目的：我们测试了通过交互式语音响应（IVR）系统实施的同伴驱动干预是否会导致更好的患者满意度（主要结果）、护理协调和CPAP依从性，与主动对照组相比。

Methods: We performed a 6-month randomized, parallel-group, controlled trial with CPAP-naive patients recruited from four centers and CPAP-adherent patients who were trained to be mentors delivering support through an IVR system.

方法：我们在四个中心招募了未使用CPAP的患者和经过培训能够通过IVR系统提供支持的CPAP依从性患者，进行了为期6个月的随机平行组对照试验。

Measurements and Main Results: In 263 patients, intention-to-treatanalysis of global satisfaction for sleep-specific services was better in the intervention group (4.57 ± 0.71 Likert scale score; mean ± SD) than in the active-control group (4.10 ± 1.13; P < 0.001).

测量和主要结果：在263名患者中，对睡眠特定服务的总体满意度进行意向治疗分析显示，干预组（4.57 ± 0.71李克特量表评分；平均值 ± 标准差）优于主动对照组（4.10 ± 1.13；P < 0.001）。

CPAP adherence was greater in the intervention group (4.5 ± 0.2 h/night; 62.0% ± 3.0% of nights >4 h use) versus the active-control group (3.7 ± 0.2 h/night; 51.4% ± 3.0% of nights >4 h use; P = 0.014 and P = 0.023).

与主动对照组相比，干预组的CPAP依从性更高（干预组：每晚4.5 ± 0.2小时；62.0% ± 3.0%的夜晚使用时间超过4小时；主动对照组：每晚3.7 ± 0.2小时；51.4% ± 3.0%的夜晚使用时间超过4小时；P = 0.014 和 P = 0.023）。

When compared with the active-control group, the Patient Assessment of Chronic Illness Care rating was moderately increased by an adjusted difference of 0.33 ± 0.12 (P = 0.009), Consumer Assessment of Healthcare Provider and Systems rating was not different (adjusted difference, 0.46 ± 0.26; P = 0.076), and Client Perception of Coordination Questionnaire was mildly better in the intervention group (adjusted difference, 0.15 ± 0.07; P = 0.035).

与活跃对照组相比，患者慢性病护理评估得分通过调整后的差异适度增加了0.33 ± 0.12（P = 0.009），消费者对医疗保健提供者和系统的评估没有差异（调整后的差异，0.46 ± 0.26；P = 0.076），而干预组的客户对协调的感知轻微改善（调整后的差异，0.15 ± 0.07；P = 0.035）。

Conclusions: Patient satisfaction with care delivery, CPAP adherence, and care coordination were improved by peer-driven intervention through an IVR system.

结论：通过IVR系统驱动的同伴干预，改善了患者对护理交付的满意度、CPAP的依从性以及护理协调。

New payor policies compensating peer support may enable implementation of this approach.

新的支付者政策对同伴支持的补偿可能会使这种方法得以实施。

Clinical trial registered with www.clinicaltrials.gov (NCT02056002).

该临床试验已在www.clinicaltrials.gov注册（NCT02056002）。