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Ethnic disparities in CPAP adherence in New Zealand: effects of socioeconomic status, health literacy and self-efficacy

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From Māori Health Review Issue 36
Authors:
  • Bakker JP et al
Summary:

In this investigation into the influence of ethnicity on continuous positive airway pressure (CPAP) adherence in New Zealand, 126 CPAP-naïve patients (19.8% Māori, mean apnoea-hypopnoea index 57.9 events/h, CPAP 11.1 cm H2O) underwent a 4-week supervised home trial of CPAP following pressure titration. After 1 month, objective CPAP adherence was significantly lower among Māori than non-Māori (median 5.11 h/night vs 5.71 h/night; p=0.05). In a multivariate logistic regression model incorporating 5 variables (ethnicity, eligibility for government-subsidised healthcare, individual deprivation scores, income, and education), non-completion of tertiary education, and high individual socioeconomic deprivation remained significant independent predictors of average CPAP adherence not reaching ≥4 h (OR 0.25, p=0.02; OR 0.10, p=0.04, respectively). The overall model explained approximately 23% of the variance in adherence

Comment:
A survey or qualitative study would also be useful to understand this phenomenon, as I suspect the reasons for non-adherence in CPAP are complex. OSA is a major health issue for Māori and CPAP is one of the most effective
Reference: Sleep. 2011;34(11):1595-603.
Abstract
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Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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