• Sairam Parthasarathy, Christopher Wendel, Michael A Grandner, Patricia L Haynes, Stefano Guerra, Daniel Combs, and Stuart F Quan.
• University of Arizona, Medicine, Tucson, Arizona, United States; sparthasarathy@deptofmed.arizona.edu.
• Am. J. Respir. Crit. Care Med. 2024 Oct 23.

RationaleObstructive sleep apnea (OSA) is a common condition that is usually treated by continuous positive airway pressure (CPAP) therapy, but poor adherence is common and is associated with worse patient outcomes and experiences. Patient satisfaction is increasingly adopted as a quality indicator by healthcare systems.ObjectiveWe tested the hypothesis that peer-driven intervention effected through interactive voice-response(PDI-IVR) system leads to better patient satisfaction (primary outcome), care-coordination, and CPAP adherence when compared to active-control.MethodsWe performed a 6-month randomized, parallel-group, controlled trial with CPAP naïve patients recruited from four centers and CPAP-adherent patients who were trained to be mentors delivering support through an IVR system.Measurements And ResultsIn 263 patients, intention-to-treat analysis global satisfaction for sleep-specific services was better in the intervention group (4.57+0.71 Likert scale score) than in the active-control group (4.10+1.13; P<0.001). CPAP adherence was greater in intervention group (4.5+0.2 hours/night; 62.0+3.0% of nights >4 hours usage) versus active-control group (3.7+0.2 hours/night; 51.4+3.0% of nights >4 hours usage; P=0.014 and P=0.023). When compared to active-control group, Patient Assessment of Chronic Illness Care ratings was moderately increased by an adjusted difference of 0.33+0.12 (P=0.009); Consumer Assessment of Healthcare Provider and Systems ratings was not different (adjusted difference of 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).ConclusionPatient satisfaction with care delivery, CPAP adherence, and care-coordination was improved by peer-driven intervention through an IVR system. New payor policies compensating peer-support may enable implementation of this approach. Clinical trial registration available at www.Clinicaltrialsgov, ID: NCT02056002.

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