Self-efficacy is an independent predictor of one-year PAP adherence trajectories

<bold>Rationale:</bold> Positive airway pressure (PAP) termination rates remain very high, and adherence to therapy is a major issue. Socio- economic status, health literacy, and self-efficacy as determinants of PAP adherence have been poorly studied and might represent significant contributors to adherence. <bold>Methods:</bold> This prospective multicenter study included patients with obstructive sleep apnea (0SA) newly initiated on PAP. Health literacy, self-efficacy and precariousness scores were collected by using the SEMSA-15 score. A latent trajectory analysis (LTA) was used to identify CPAP adherence trajectories. <bold>Results:</bold> 293 OSA patients with CPAP adherence data at 1 year were included. The patients were aged 55 years (median, [IQR]) [47; 64], predominantly male (70%), with an initial BMI of 31.6 kg/m² [28; 36] and an apnea-hypopnea index of 43 events/h [35; 56]. Three CPAP adherence trajectories were identified by LTA: CPAP termination(N=36 (12%), intermediate adherence N=98 (35%)) and high adherence (N=159 (53%)), Figure 1. After adjustment on age, sex, BMI, AHI, comorbidities, an SEMSA-15 score and BMI were significantly associated to adherence trajectories. <fig><object-id>erj;64/suppl_68/OA5440/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusion:</bold> SEMSAS is the first study using multidimensional baseline assessment to identify CPAP adherence trajectories. Self-efficacy can be considered as an independent predictor of CPAP adherence trajectories.