human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To examine whether a social cognitive therapy ( SCT ) intervention increases continuous positive airway pressure ( CPAP ) use compared to equivalent social interaction ( SI ) time . PARTICIPANTS Individuals with obstructive sleep apnea ( OSA ) referred for CPAP therapy . INTERVENTION Participants received a 30-min group education session regarding OSA and CPAP . Groups of three to four participants were then r and omly assigned to an SCT session or social interaction . MEASUREMENTS CPAP usage was assessed at 7 nights , then 1 , 3 , and 6 months . The two primary outcomes were adherence , usage ≥ 4 h per night at 6 months , and uptake of CPAP . Question naires were given pretreatment and posttreatment . RESULTS Two hundred six individuals were r and omized to SI ( n = 97 ) or SCT ( n = 109 ) . CPAP uptake was not different between groups ( 82 % in SI , 88 % in SCT groups , P = 0.35 ) . There were no differences between groups in adherence : 63 - 66 % at 1 week , and at 6 months 55 - 47 % ( P = 0.36 ) . Higher pretreatment apnea-hypopnea index , higher baseline self-efficacy , and use of CPAP ( ≥ 4 h ) at 1 week were independent predictors of CPAP adherence at 6 months . CPAP adherence increased by a factor of 1.8 ( odds ratio = 1.8 , 95 % confidence interval 1.1 - 3.0 ) for every one-unit increase in self-efficacy . There was no difference between groups postintervention in self-efficacy scores , sleepiness , mood , or sleep quality . CONCLUSIONS In this r and omized trial , a single SCT application did not increase adherence when compared with SI time . Although self-efficacy scores prior to CPAP predicted adherence , self-efficacy was not increased by the interventions . Increasing intensity and underst and ing of SCT interventions may be needed to improve CPAP adherence . CLINICAL TRIALS REGISTRATION Australian New Zeal and Clinical Trials Registry , ACTRN12607000424404 Objectives To evaluate the completeness of descriptions of non-pharmacological interventions in r and omised trials , identify which elements are most frequently missing , and assess whether authors can provide missing details . Design Analysis of consecutive sample of r and omised trials of non-pharmacological interventions . Data sources and study selection All reports of r and omised trials of non-pharmacological interventions published in 2009 in six leading general medical journals ; 133 trial reports , with 137 interventions , met the inclusion criteria . Data collection Using an eight item checklist , two raters assessed the primary full trial report , plus any reference material s , appendices , or websites . Questions about missing details were emailed to corresponding authors , and relevant items were then reassessed . Results Of 137 interventions , only 53 ( 39 % ) were adequately described ; this was increased to 81 ( 59 % ) by using 63 responses from 88 contacted authors . The most frequently missing item was the “ intervention material s ” ( 47 % complete ) , but it also improved the most after author response ( 92 % complete ) . Whereas some authors ( 27/70 ) provided material s or further information , other authors ( 21/70 ) could not ; their reasons included copyright or intellectual property concerns , not having the material s or intervention details , or being unaware of their importance . Although 46 ( 34 % ) trial interventions had further information or material s readily available on a website , many were not mentioned in the report , were not freely accessible , or the URL was no longer functioning . Conclusions Missing essential information about interventions is a frequent , yet remediable , contributor to the worldwide waste in research funding . If trial reports do not have a sufficient description of interventions , other research ers can not build on the findings , and clinicians and patients can not reliably implement useful interventions . Improvement will require action by funders , research ers , and publishers , aided by long term repositories of material s linked to publications The present study examined the efficacy of a cognitive-behavioral intervention at improving compliance with CPAP  and vigilance in older adults with obstructive sleep apnea/hypopnea syndrome ( OSAHS ) . Participants included 12 subjects who were r and omized into one of two groups controlling for age , education , disease severity , and vigilance . The experimental group received two 45-min sessions design ed to educate subjects on the consequences of OSAHS and the efficacy of CPAP . The control group received the same extent of therapist contact but did not receive information on OSAHS or CPAP . All subjects were administered a test of vigilance both before and after the study . Compliance data were collected using CPAP devices with internal microprocessors at were read at 1 , 4 , and 12 weeks after treatment initiation . The results showed that the experimental condition did not enhance compliance after 1 week of treatment but did so by the 12-week follow-up . Subjects in the experimental condition had a run time of 3.2-h per night longer than did those in the control group . Those using CPAP more regularly at 12 weeks also showed greater improvement on vigilance at follow-up . Performance on vigilance testing before the introduction of CPAP was predictive of CPAP use at 12 weeks . In conclusion , a modest cognitive-behavioral intervention may substantially increase  CPAP use and vigilance in older adults This study compared the effects of a the oretically focused audiotape and a st and ard educational booklet on asthma preventive medication adherence and other asthma outcomes .  Forty-six adult asthmatics were r and omly assigned to receive either an experimental audiotape incorporating components of protection motivation theory , a st and ard asthma management booklet , both , or no educational material s. Outcomes were assessed at baseline , 3 months , and 6 months . Mean pharmacy-verified adherence improved 15 % to 19 % in the intervention groups and declined 22 % in the control group at 6 months . Using analysis of covariance ( ANCOVA ) to control for baseline adherence , these changes were significant between the control and booklet group ( t = 2.47 ; p = .02 ) and between control and combined group ( t = 2.07 ; p = .04 ) . Providing a minimal educational intervention can have a beneficial effect on asthma medication adherence that persists at least 6 months The purpose of this study was to evaluate the impact of a self-management program for adults with moderate to severe asthma on compliance with inhaled , prescribed , nonemergency medications ; asthma symptoms ; and airway obstruction . In this controlled experimental study , 55 subjects from a rural community were r and omized to one of two groups . Self-efficacy theory served as the framework for this study . Primary measures included the  Metered Dose Inhaler ( MDI ) Chronolog , a journal of daily asthma concerns , and a peak-flow meter to appraise airway obstruction . Secondary measures included the Asthma Self-Management Assessment Tool ( ASMAT ) and the Self-Efficacy for Asthma Management Scale ( SEAMS ) . These measures were completed pre- and post-intervention . Data analysis using descriptive and inferential statistics revealed that subjects receiving the self-management program increased compliance with inhaled medications ( U = 271 , p = .043 ) Background Continuous positive airway pressure ( CPAP ) is the most widely prescribed treatment for obstructive sleep apnoea syndrome ( OSAS ) . Although it has been shown to improve the symptoms of OSAS , many patients have difficulty adhering to this treatment . The purpose of this study was to investigate the effectiveness of an automated telemedicine intervention to improve adherence to CPAP . Methods A r and omised clinical trial was undertaken in 250 patients being started on CPAP therapy for OSAS . Patients were r and omly assigned to use a theory-driven interactive voice response system design ed to improve CPAP adherence ( telephone-linked communications for CPAP ( TLC-CPAP ) , n=124 ) or to an attention placebo control ( n=126 ) for 12 months . TLC-CPAP monitors patients ' self-reported behaviour and CPAP-related symptoms and provides feedback and counselling through a structured dialogue to enhance motivation to use CPAP . A Sleep Symptoms Checklist , the Functional Outcomes of Sleep Question naire , the Center for Epidemiological Studies Depression Scale and the Psychomotor Vigilance Task were administered at study entry and at 6-month and 12-month follow-up . Hours of CPAP usage at effective mask pressure were measured by the CPAP device stored in its memory and retrieved at each visit . Results Median observed CPAP use in patients r and omised to TLC-CPAP was approximately 1 h/night higher than in the control subjects at 6 months and 2 h/night higher at 12 months . Using generalised estimating equation modelling , the intervention had a significant effect on CPAP adherence . For secondary analysis , the effect of CPAP adherence on the secondary outcomes was analysed . CPAP adherence was significantly associated with a greater reduction in sleep apnoea symptoms and depressive symptoms and a greater improvement in functional status . No significant association was observed between CPAP adherence and reaction time . Conclusions The TLC-CPAP intervention result ed in improved CPAP adherence , which was associated with improved functional status and fewer depressive symptoms . Clinical trial.gov NCT00232544 OBJECTIVE As many as 50 % of patients diagnosed with obstructive sleep apnea stop adhering to the prescribed medical treatment of continuous positive airway pressure ( CPAP ) within 1 - 3 weeks of onset . Thus , a theory-based intervention using music to support habit formation was design ed to improve CPAP adherence at onset . The intervention material s included directions for CPAP nightly use , a diary for recording nightly use and writing about CPAP benefits or problems . In addition , an audiotape with softly spoken instructions for placing the CPAP mask comfortably , using deep breathing and muscle relaxation along with the slowly decreasing music tempo was provided to listen to at bedtime each night . METHODS Effects of this music intervention were tested in a r and omized , placebo-controlled trial of 97 patients with 53 males ( 55 % ) and 44 females ( 45 % ) . Moderate to severe apnea/hyponea scores ( per sleep laboratory data ) and medical diagnosis of OSA were required for study inclusion . RESULTS Compared to placebo controls , a greater proportion of experimental patients were adhering ( chi(2)=14.67 , p<0.01 ; a large difference , Phi=0.39 ) at the end of the first month of CPAP onset . There were no differences in CPAP adherence at 3 ( X(2)=0.065 , p=0.79 ) and 6 ( X(2)=.118 , p=0.73 ) months . Patients ' diary data and satisfaction survey results indicated the intervention was rated as helpful and guided formation of a relaxing , habitual routine of CPAP nightly use . CONCLUSION The intervention had a strong effect for improving adherence to CPAP at 1 month . PRACTICE IMPLICATION S Adherence at the onset of treatment is critical and the audio music intervention was easily administered . Other interventions that target problems interfering with longer-term CPAP adherence are needed Objective : This study was conducted to test the effectiveness of a theory-based interactive voice response ( IVR ) intervention to improve adherence to controller medications among adults with asthma . Methods : Fifty participants aged 18 to 65 years who had a physician diagnosis of asthma and a prescription for a daily inhaled corticosteroid , attended a baseline visit and a final visit 10 weeks later . Participants r and omized to the intervention group received 2 automated IVR telephone calls separated by one month , with one additional call if they reported recent symptoms of poorly controlled disease or failure to fill a prescription . Calls were completed in less than 5 minutes and included content design ed to inquire about asthma symptoms , deliver core educational messages , encourage refilling of inhaled corticosteroid prescriptions , and increase communication with providers . Adherence was tracked during 10 weeks , with objective measures that included either electronic monitors or calculation of canister weight . Participants completed the Asthma Quality of Life Question naire , the Asthma Control Test , and the Beliefs in Medications Question naire ( BMQ ) during both visits . Results : Adherence was 32 % higher among patients in the IVR group than those in the control group ( P = .003 ) . A more favorable shift in perception of inhaled corticosteroids was seen on BMQ scores of patients in the IVR group ( P = .003 ) , which in turn correlated with degree of adherence change ( r = 0.342 ; P = .0152 ) . No differences emerged for the Asthma Quality of Life Question naire or Asthma Control Test . Conclusions : The IVR intervention result ed in a significant increase in adherence to inhaled corticosteroid treatment and improved BMQ scores during the study interval . The association of increased adherence with increased BMQ scores suggests that the intervention succeeded in helping participants adopt a more favorable perception of their controller medication , leading in turn to improved adherence BACKGROUND Difficult to control asthma accounts for significant morbidity and healthcare cost , and non-adherence to medication is a common cause . It remains unclear if targeting non-adherence in this population improves healthcare outcomes . METHODS All subjects were referred to a Specialist Difficult Asthma Service ( 60 % from Respiratory physicians ) ; poor adherence was identified using prescription refill records for inhaled combination therapy . A sequential 2 phase study examined the effect of identifying and targeting non-adher 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To examine whether a social cognitive therapy ( SCT ) intervention increases continuous positive airway pressure ( CPAP ) use compared to equivalent social interaction ( SI ) time . PARTICIPANTS Individuals with obstructive sleep apnea ( OSA ) referred for CPAP therapy . INTERVENTION Participants received a 30-min group education session regarding OSA and CPAP . Groups of three to four participants were then r and omly assigned to an SCT session or social interaction . MEASUREMENTS CPAP usage was assessed at 7 nights , then 1 , 3 , and 6 months . The two primary outcomes were adherence , usage ≥ 4 h per night at 6 months , and uptake of CPAP . Question naires were given pretreatment and posttreatment . RESULTS Two hundred six individuals were r and omized to SI ( n = 97 ) or SCT ( n = 109 ) . CPAP uptake was not different between groups ( 82 % in SI , 88 % in SCT groups , P = 0.35 ) . There were no differences between groups in adherence : 63 - 66 % at 1 week , and at 6 months 55 - 47 % ( P = 0.36 ) . Higher pretreatment apnea-hypopnea index , higher baseline self-efficacy , and use of CPAP ( ≥ 4 h ) at 1 week were independent predictors of CPAP adherence at 6 months . CPAP adherence increased by a factor of 1.8 ( odds ratio = 1.8 , 95 % confidence interval 1.1 - 3.0 ) for every one-unit increase in self-efficacy . There was no difference between groups postintervention in self-efficacy scores , sleepiness , mood , or sleep quality . CONCLUSIONS In this r and omized trial , a single SCT application did not increase adherence when compared with SI time . Although self-efficacy scores prior to CPAP predicted adherence , self-efficacy was not increased by the interventions . Increasing intensity and underst and ing of SCT interventions may be needed to improve CPAP adherence . CLINICAL TRIALS REGISTRATION Australian New Zeal and Clinical Trials Registry , ACTRN12607000424404 Objectives To evaluate the completeness of descriptions of non-pharmacological interventions in r and omised trials , identify which elements are most frequently missing , and assess whether authors can provide missing details . Design Analysis of consecutive sample of r and omised trials of non-pharmacological interventions . Data sources and study selection All reports of r and omised trials of non-pharmacological interventions published in 2009 in six leading general medical journals ; 133 trial reports , with 137 interventions , met the inclusion criteria . Data collection Using an eight item checklist , two raters assessed the primary full trial report , plus any reference material s , appendices , or websites . Questions about missing details were emailed to corresponding authors , and relevant items were then reassessed . Results Of 137 interventions , only 53 ( 39 % ) were adequately described ; this was increased to 81 ( 59 % ) by using 63 responses from 88 contacted authors . The most frequently missing item was the “ intervention material s ” ( 47 % complete ) , but it also improved the most after author response ( 92 % complete ) . Whereas some authors ( 27/70 ) provided material s or further information , other authors ( 21/70 ) could not ; their reasons included copyright or intellectual property concerns , not having the material s or intervention details , or being unaware of their importance . Although 46 ( 34 % ) trial interventions had further information or material s readily available on a website , many were not mentioned in the report , were not freely accessible , or the URL was no longer functioning . Conclusions Missing essential information about interventions is a frequent , yet remediable , contributor to the worldwide waste in research funding . If trial reports do not have a sufficient description of interventions , other research ers can not build on the findings , and clinicians and patients can not reliably implement useful interventions . Improvement will require action by funders , research ers , and publishers , aided by long term repositories of material s linked to publications The present study examined the efficacy of a cognitive-behavioral intervention at improving compliance with CPAP  and vigilance in older adults with obstructive sleep apnea/hypopnea syndrome ( OSAHS ) . Participants included 12 subjects who were r and omized into one of two groups controlling for age , education , disease severity , and vigilance . The experimental group received two 45-min sessions design ed to educate subjects on the consequences of OSAHS and the efficacy of CPAP . The control group received the same extent of therapist contact but did not receive information on OSAHS or CPAP . All subjects were administered a test of vigilance both before and after the study . Compliance data were collected using CPAP devices with internal microprocessors at were read at 1 , 4 , and 12 weeks after treatment initiation . The results showed that the experimental condition did not enhance compliance after 1 week of treatment but did so by the 12-week follow-up . Subjects in the experimental condition had a run time of 3.2-h per night longer than did those in the control group . Those using CPAP more regularly at 12 weeks also showed greater improvement on vigilance at follow-up . Performance on vigilance testing before the introduction of CPAP was predictive of CPAP use at 12 weeks . In conclusion , a modest cognitive-behavioral intervention may substantially increase  CPAP use and vigilance in older adults This study compared the effects of a the oretically focused audiotape and a st and ard educational booklet on asthma preventive medication adherence and other asthma outcomes .  Forty-six adult asthmatics were r and omly assigned to receive either an experimental audiotape incorporating components of protection motivation theory , a st and ard asthma management booklet , both , or no educational material s. Outcomes were assessed at baseline , 3 months , and 6 months . Mean pharmacy-verified adherence improved 15 % to 19 % in the intervention groups and declined 22 % in the control group at 6 months . Using analysis of covariance ( ANCOVA ) to control for baseline adherence , these changes were significant between the control and booklet group ( t = 2.47 ; p = .02 ) and between control and combined group ( t = 2.07 ; p = .04 ) . Providing a minimal educational intervention can have a beneficial effect on asthma medication adherence that persists at least 6 months The purpose of this study was to evaluate the impact of a self-management program for adults with moderate to severe asthma on compliance with inhaled , prescribed , nonemergency medications ; asthma symptoms ; and airway obstruction . In this controlled experimental study , 55 subjects from a rural community were r and omized to one of two groups . Self-efficacy theory served as the framework for this study . Primary measures included the  Metered Dose Inhaler ( MDI ) Chronolog , a journal of daily asthma concerns , and a peak-flow meter to appraise airway obstruction . Secondary measures included the Asthma Self-Management Assessment Tool ( ASMAT ) and the Self-Efficacy for Asthma Management Scale ( SEAMS ) . These measures were completed pre- and post-intervention . Data analysis using descriptive and inferential statistics revealed that subjects receiving the self-management program increased compliance with inhaled medications ( U = 271 , p = .043 ) Background Continuous positive airway pressure ( CPAP ) is the most widely prescribed treatment for obstructive sleep apnoea syndrome ( OSAS ) . Although it has been shown to improve the symptoms of OSAS , many patients have difficulty adhering to this treatment . The purpose of this study was to investigate the effectiveness of an automated telemedicine intervention to improve adherence to CPAP . Methods A r and omised clinical trial was undertaken in 250 patients being started on CPAP therapy for OSAS . Patients were r and omly assigned to use a theory-driven interactive voice response system design ed to improve CPAP adherence ( telephone-linked communications for CPAP ( TLC-CPAP ) , n=124 ) or to an attention placebo control ( n=126 ) for 12 months . TLC-CPAP monitors patients ' self-reported behaviour and CPAP-related symptoms and provides feedback and counselling through a structured dialogue to enhance motivation to use CPAP . A Sleep Symptoms Checklist , the Functional Outcomes of Sleep Question naire , the Center for Epidemiological Studies Depression Scale and the Psychomotor Vigilance Task were administered at study entry and at 6-month and 12-month follow-up . Hours of CPAP usage at effective mask pressure were measured by the CPAP device stored in its memory and retrieved at each visit . Results Median observed CPAP use in patients r and omised to TLC-CPAP was approximately 1 h/night higher than in the control subjects at 6 months and 2 h/night higher at 12 months . Using generalised estimating equation modelling , the intervention had a significant effect on CPAP adherence . For secondary analysis , the effect of CPAP adherence on the secondary outcomes was analysed . CPAP adherence was significantly associated with a greater reduction in sleep apnoea symptoms and depressive symptoms and a greater improvement in functional status . No significant association was observed between CPAP adherence and reaction time . Conclusions The TLC-CPAP intervention result ed in improved CPAP adherence , which was associated with improved functional status and fewer depressive symptoms . Clinical trial.gov NCT00232544 OBJECTIVE As many as 50 % of patients diagnosed with obstructive sleep apnea stop adhering to the prescribed medical treatment of continuous positive airway pressure ( CPAP ) within 1 - 3 weeks of onset . Thus , a theory-based intervention using music to support habit formation was design ed to improve CPAP adherence at onset . The intervention material s included directions for CPAP nightly use , a diary for recording nightly use and writing about CPAP benefits or problems . In addition , an audiotape with softly spoken instructions for placing the CPAP mask comfortably , using deep breathing and muscle relaxation along with the slowly decreasing music tempo was provided to listen to at bedtime each night . METHODS Effects of this music intervention were tested in a r and omized , placebo-controlled trial of 97 patients with 53 males ( 55 % ) and 44 females ( 45 % ) . Moderate to severe apnea/hyponea scores ( per sleep laboratory data ) and medical diagnosis of OSA were required for study inclusion . RESULTS Compared to placebo controls , a greater proportion of experimental patients were adhering ( chi(2)=14.67 , p<0.01 ; a large difference , Phi=0.39 ) at the end of the first month of CPAP onset . There were no differences in CPAP adherence at 3 ( X(2)=0.065 , p=0.79 ) and 6 ( X(2)=.118 , p=0.73 ) months . Patients ' diary data and satisfaction survey results indicated the intervention was rated as helpful and guided formation of a relaxing , habitual routine of CPAP nightly use . CONCLUSION The intervention had a strong effect for improving adherence to CPAP at 1 month . PRACTICE IMPLICATION S Adherence at the onset of treatment is critical and the audio music intervention was easily administered . Other interventions that target problems interfering with longer-term CPAP adherence are needed Objective : This study was conducted to test the effectiveness of a theory-based interactive voice response ( IVR ) intervention to improve adherence to controller medications among adults with asthma . Methods : Fifty participants aged 18 to 65 years who had a physician diagnosis of asthma and a prescription for a daily inhaled corticosteroid , attended a baseline visit and a final visit 10 weeks later . Participants r and omized to the intervention group received 2 automated IVR telephone calls separated by one month , with one additional call if they reported recent symptoms of poorly controlled disease or failure to fill a prescription . Calls were completed in less than 5 minutes and included content design ed to inquire about asthma symptoms , deliver core educational messages , encourage refilling of inhaled corticosteroid prescriptions , and increase communication with providers . Adherence was tracked during 10 weeks , with objective measures that included either electronic monitors or calculation of canister weight . Participants completed the Asthma Quality of Life Question naire , the Asthma Control Test , and the Beliefs in Medications Question naire ( BMQ ) during both visits . Results : Adherence was 32 % higher among patients in the IVR group than those in the control group ( P = .003 ) . A more favorable shift in perception of inhaled corticosteroids was seen on BMQ scores of patients in the IVR group ( P = .003 ) , which in turn correlated with degree of adherence change ( r = 0.342 ; P = .0152 ) . No differences emerged for the Asthma Quality of Life Question naire or Asthma Control Test . Conclusions : The IVR intervention result ed in a significant increase in adherence to inhaled corticosteroid treatment and improved BMQ scores during the study interval . The association of increased adherence with increased BMQ scores suggests that the intervention succeeded in helping participants adopt a more favorable perception of their controller medication , leading in turn to improved adherence BACKGROUND Difficult to control asthma accounts for significant morbidity and healthcare cost , and non-adherence to medication is a common cause . It remains unclear if targeting non-adherence in this population improves healthcare outcomes . METHODS All subjects were referred to a Specialist Difficult Asthma Service ( 60 % from Respiratory physicians ) ; poor adherence was identified using prescription refill records for inhaled combination therapy . A sequential 2 phase study examined the effect of identifying and targeting non-adher 
    Output:
    