{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:19:43Z","timestamp":1788239983194,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with Duchenne muscular dystrophy (DMD) have progressive muscular weakness, respiratory decline and often have poor adherence to nocturnal non\u2010invasive positive airway pressure ventilation (NIPPV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 2020, we sought to increase nocturnal NIPPV adherence (\u2265\u20094\u2009h use overnight on at least 65% of nights) from 33% to 75% by December 2024 at a pediatric neuromuscular center. We used quality improvement (QI) methods and identified key drivers (follow\u2010up, education, staff engagement, consistent documentation). Interventions included: assuring timely follow\u2010up (within \u2264\u200914 months), pre\u2010visit planning, reminders to bring NIPPV equipment to clinic, addressing adherence barriers and partnering with psychologists. Improving overnight NIPPV adherence was the primary outcome measure. Process measures included the proportion of patients with: (1) NIPPV equipment in the clinic, (2) timely follow\u2010up, and (3) a properly documented follow\u2010up call. Measures were tracked on run charts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline median adherence improved from 33% to 60% in 8 months, and subsequently to 74% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009181). The proportion of patients with NIPPV machines in the clinic increased (53%\u201382%), as did the proportion of patients with timely follow\u2010up (81%\u201395%). Common patient\u2010reported (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009123) adherence barriers included: \u201csleeping well without NIPPV\u201d (20%), \u201cair pressure discomfort\u201d (14%) and \u201cfalling asleep before putting it on\u201d (14%). Common parent\u2010reported barriers were: \u201cforget to use\u201d (17%) and \u201cfall asleep before putting it on\u201d (15%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nocturnal NIPPV adherence improved in youth with DMD using QI methods. Tracking adherence automatically via equipment records, further investigating barriers and minimizing discomfort with NIPPV may further improve adherence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71765","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T07:12:28Z","timestamp":1785481948000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving Nocturnal Non\u2010Invasive Positive Pressure Support Adherence in Children and Young Adults With Duchenne Muscular Dystrophy"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9590-996X","authenticated-orcid":false,"given":"John E.","family":"Pascoe","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3354-2853","authenticated-orcid":false,"given":"Neepa","family":"Gurbani","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6960-8143","authenticated-orcid":false,"given":"Daniel","family":"Ignatiuk","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Grad","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7241-5502","authenticated-orcid":false,"given":"Danielle M.","family":"Simmons","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"},{"name":"Division of Behavioral Medicine and Clinical Psychology Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sketch","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Rolsen","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Mullen","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9329-9459","authenticated-orcid":false,"given":"Christine L.","family":"Schuler","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"},{"name":"Division of Hospital Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0478-7205","authenticated-orcid":false,"given":"Hemant","family":"Sawnani","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Sleep Medicine Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.112.4.1024"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/children10101675"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00059906"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spen.2023.101092"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26448"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000000074"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9678"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.36185\/2532-1900-553"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12185866"},{"key":"e_1_2_10_11_1","volume-title":"Non\u2010Invasive Ventilation (NIV) in Duchenne Muscular Dystrophy: A Review of 17 Years of Practice","author":"Beesley V.","year":"2016"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleepadvances\/zpae046"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27848"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9400"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24484"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23645"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.FCH.0000290542.10458.f8"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/1091-7527.24.4.381"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2589-7500(19)30214-6"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2020.101273"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.2196\/27999"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1037\/cpp0000459"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-021-02588-1"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.2196\/24893"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0254890"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71765","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.71765","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71765","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:04:17Z","timestamp":1788239057000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71765"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/ppul.71765"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71765","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]},"assertion":[{"value":"2026-02-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71765"}}