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Compliance With CPAP at 6 Weeks Following Initial Set Up at the Physician Office
Sleep Disorders SESSION TITLE: Sleep Disorders I SESSION TYPE: Original Investigation Poster PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM
Compliance With CPAP at 6 Weeks Following Initial Set Up at the Physician Office Narayan Krishnamurthy MD* CSBD, Tuscaloosa, AL PURPOSE: Untreated OSA is associated with hypertension and vascular disease, cognitive dysfunction, and increased motor vehicle accident as well as work related risk. Positive airway pressure (PAP) is considered the standard of care for moderate to severe OSA. However, treatment benefits may depend on the compliance with CPAP use. Many studies suggest that only a minority of patients use CPAP as recommended METHODS: Following CPAP titration study, patients are seen for follow up with in days to discuss findings and options to treat. Those who opted to be set up by us were carried out by the RN* certified in sleep education under the direct supervision of the sleep physician@. The mask was fitted as best as possible and was confirmed by physician for leaks, comfort with the CPAP set at the prescribed pressure. Any difficulty with usage was immediately attended to including changing the mask repeatedly till achieving desired comfort. Follow up appointment was made after 6 weeks. The computer data base was downloaded to obtain compliance data. RESULTS: 118 Patients with OSA were fitted with CPAP between Dec 2013 and July 2015. Computer generated data at 6 weeks were obtained at follow up on 108 patients. 9 patients were lost to follow up due to moving away and could not be contacted. 1 patient returned the machine due to unwillingness. Out of the patients seen at follow up the compliant data is as follows: Compliance at 6 weeks: 4 hrs. or more usage per night (Medicare criteria) 91 patients > 70 % usage 17 patients < 70 % usage. Overall, 6 weeks compliance per Medicare criteria was 77% with nearly half of the total reaching over 90% compliance. If we leave out those who could not be followed up, our compliance reaches 84% by Medicare criteria.
SLEEP DISORDERS
CONCLUSIONS: Patterns of CPAP use develop as early as the first week of treatment and there is data to suggest early intervention and reinforcement is key to compliance. However, the compliance remains poor and much to be desired. Few studies have evaluated effect of initial set up in a familiar place by a team approach involving physician-nurse-RT as a one stop education and CPAP set up. We believe that making it a combined effort with involvement of patient at each step of decision making enabled us to achieve a high initial compliance. CLINICAL IMPLICATIONS: Direct physician-team involvement improve CPAP compliance DISCLOSURE: The following authors have nothing to disclose: Narayan Krishnamurthy No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.02.589
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
564A
[
149#4S CHEST APRIL 2016
]
Compliance With CPAP at 6 Weeks Following Initial Set Up at the Physician Office Narayan Krishnamurthy MD* CSBD, Tuscaloosa, AL PURPOSE: Untreated OSA is associated with hypertension and vascular disease, cognitive dysfunction, and increased motor vehicle accident as well as work related risk. Positive airway pressure (PAP) is considered the standard of care for moderate to severe OSA. However, treatment benefits may depend on the compliance with CPAP use. Many studies suggest that only a minority of patients use CPAP as recommended METHODS: Following CPAP titration study, patients are seen for follow up with in days to discuss findings and options to treat. Those who opted to be set up by us were carried out by the RN* certified in sleep education under the direct supervision of the sleep physician@. The mask was fitted as best as possible and was confirmed by physician for leaks, comfort with the CPAP set at the prescribed pressure. Any difficulty with usage was immediately attended to including changing the mask repeatedly till achieving desired comfort. Follow up appointment was made after 6 weeks. The computer data base was downloaded to obtain compliance data. RESULTS: 118 Patients with OSA were fitted with CPAP between Dec 2013 and July 2015. Computer generated data at 6 weeks were obtained at follow up on 108 patients. 9 patients were lost to follow up due to moving away and could not be contacted. 1 patient returned the machine due to unwillingness. Out of the patients seen at follow up the compliant data is as follows: Compliance at 6 weeks: 4 hrs. or more usage per night (Medicare criteria) 91 patients > 70 % usage 17 patients < 70 % usage. Overall, 6 weeks compliance per Medicare criteria was 77% with nearly half of the total reaching over 90% compliance. If we leave out those who could not be followed up, our compliance reaches 84% by Medicare criteria.
SLEEP DISORDERS
CONCLUSIONS: Patterns of CPAP use develop as early as the first week of treatment and there is data to suggest early intervention and reinforcement is key to compliance. However, the compliance remains poor and much to be desired. Few studies have evaluated effect of initial set up in a familiar place by a team approach involving physician-nurse-RT as a one stop education and CPAP set up. We believe that making it a combined effort with involvement of patient at each step of decision making enabled us to achieve a high initial compliance. CLINICAL IMPLICATIONS: Direct physician-team involvement improve CPAP compliance DISCLOSURE: The following authors have nothing to disclose: Narayan Krishnamurthy No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.02.589
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
564A
[
149#4S CHEST APRIL 2016
]