{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:47:30Z","timestamp":1791830850145,"version":"4.3.4"},"reference-count":31,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Domiciliary noninvasive ventilation (NIV) is a standard treatment for improving health outcomes among patients with chronic hypercapnic respiratory failure (CHRF). However, poor adherence substantially limits its therapeutic effectiveness.<\/jats:p><\/jats:sec>Objective<\/jats:title>To determine the effect of an information-motivation-behavioral (IMB) skills-based intervention (IMB-NIV program) on NIV adherence, patient-reported health outcomes, and health service use among patients with CHRF.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This multisite, assessor-blinded, randomized clinical trial was conducted from January 2022 to March 2023 at respiratory clinics of 2 regional hospitals in Hong Kong among patients with CHRF who had been nonadherent to prescribed domiciliary NIV.<\/jats:p><\/jats:sec>Interventions<\/jats:title>The 6-week IMB-NIV program used a hybrid approach, combining in-person and telecare sessions, to provide patients with knowledge, skills, a positive attitude, and social motivation to enhance NIV adherence.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was NIV adherence data retrieved from the NIV machine. Secondary outcomes included the Pittsburgh Sleep Quality Index, Chinese Severe Respiratory Insufficiency questionnaire, venous bicarbonate (HCO3<\/jats:sub>\u2212<\/jats:sup>) level, emergency department (ED) and hospital admissions, and mortality measured at baseline, program completion, and 3, 6, and 12 months.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 124 participants (mean [SD] age, 73.7 [7.2] years; 67 [54.0%] female), the 62 patients in the IMB-NIV group were more likely to adhere to NIV compared with the 62 patients in the usual care group at 12 months (61.3% vs 27.4%; odds ratio, 2.78; 95% CI, 1.69 to 4.55), with a greater increase noted in daily NIV use in hours at that time (B\u2009=\u20092.37; 95% CI, 1.44 to 3.31). A generalized estimating equation indicated significantly greater improvements in sleep quality (B\u2009=\u2009\u22123.63; 95% CI, \u22125.14 to \u22122.12) and health-related quality of life (\u03b2\u2009=\u200914.84; 95% CI, 9.18 to 20.49) at 12 months in the IMB-NIV group. The IMB-NIV group had significantly lower ED admissions (incidence rate ratio, 0.47; 95% CI, 0.26 to 0.84) and a longer time to the first ED visit (hazard ratio, 0.51; 95% CI, 0.28 to 0.95). No significant treatment effect was observed on venous HCO3<\/jats:sub>\u2212<\/jats:sup> levels or hospital admissions.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this randomized clinical trial, the IMB-NIV program offered a promising behavioral approach to improve NIV adherence in patients with CHRF. Its sustained positive effects on sleep quality, health-related quality of life, and ED admissions highlight its potential to optimize the therapeutic benefits of NIV.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT05008211<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.51614","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T16:32:04Z","timestamp":1735230724000},"page":"e2451614","source":"Crossref","is-referenced-by-count":4,"title":["Health Communication and Adherence to Noninvasive Ventilation in Chronic Hypercapnic Respiratory Failure"],"prefix":"10.1001","volume":"7","author":[{"given":"Doris Sau Fung","family":"Yu","sequence":"first","affiliation":[{"name":"School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polly 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