0564 Group Motivational Interviewing to Improve APAP Adherence: A Quality Improvement Project

Abstract Introduction Automatic positive airway pressure (APAP) adherence to treat obstructive sleep apnea (OSA) is challenging to many patients. Motivational interviewing in one-on-one sessions has been shown to improve rates of APAP adherence. The goal of our improvement study was to improve APAP adherence and determine whether motivational interviewing is effective in a group setting. Methods Patients with a new diagnosis of OSA, regardless of severity, presented to our academic sleep disorders center for a group presentation on OSA and available treatments from November – December 2023. Groups of 5-10 patients received either a standard informative presentation or the same presentation with motivational interviewing techniques. Questionnaires with a Likert scale from 1 to 10 assessed pre- and post-presentation readiness to undergo treatment for their OSA and perceptions of importance to treat. Post-presentation questionnaires also included questions on likeliness to pursue treatment and confidence to pursue treatment. Results A total of 41 patients attended the group session with 53.6% (n=22) receiving the motivational interviewing component. For the motivational interviewing group, adherence data post-intervention revealed that the average total days of APAP use was 79%, average total hours used was 232.00 minutes, and average use greater than 4 hours was 51.6%. For the non-motivational interviewing group, adherence data post-intervention showed that the average total days of APAP use was 68.62%, average total hours used was 209.62 minutes, and average use greater than 4 hours was 46.54%. To date, 38% of non-motivational interviewing patients (n=13) were adherent by Medicare definition, compared to 40% of motivational interviewing patients (n=5). Questionnaires had equivocal scores in all categories pre- and post-presentation for the motivational interviewing and non-motivational interviewing groups and indicated a high level of motivation to pursue therapy. Conclusion Implementing motivational interviewing in a group setting was a feasible way to improve APAP adherence in our clinic. Patients are motivated to pursue APAP therapy in pre- and post-presentation questionnaires. This preliminary data is limited by ongoing intervention implementation yet promising for the use of motivational interviewing in the group setting. To the authors knowledge, no published improvement projects exist for evaluating the effectiveness of motivational interviewing in a group setting. Support (if any)