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Blog Feature

By: Kevin Asp on April 8th, 2016

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Free Fall Course Video: Optimizing PAP Adherence

Sleep Medicine


Learn how to optimize OSA therapy adherence among your patients

Positive airway pressure (PAP) compliance is a hot topic among sleep technologists who work extensively with sleep apnea patients.

This is why we are offering free access to our fall course module on OSA therapy adherence!

Despite the widespread usage of PAP therapy as a treatment option, about 46 to 83 percent of patients with obstructive sleep apnea are reported to be nonadherent (do not meet the 4 hours or more nightly usage requirement) to treatment. We wrote about some of the mask issues related to using PAP therapy as a treatment option, which include the feeling of claustrophobia and lack of proper initiation to PAP equipment among others.

But why is nonadherence such a big deal?

Scientific evidence suggests that undergoing PAP therapy for more than 6 hours per night decreases sleepiness, improves productivity and alertness and even restores memory to normal levels. In other words, PAP is a useful tool that resolves symptoms of obstructive sleep apnea (also known as OSA) and is one of the most effective treatment options.  Pap therapies and adherence were addressed in our recent fall Advanced Therapies Course and all of these learning modules will be available on the AAST website soon.

The risks associated with OSA such as hypertension, heart failure, heart arrhythmia, stroke, diabetes, excessive daytime somnolence, sexual dysfunction, and depression are rather significant, making it increasingly more important for technologists to find ways to help patients to increase adherence levels.

What are the most effective tips for increasing PAP adherence rates at your facility?

1. Find out what your practice’s real patient adherence rate is 

Your overall patient adherence rate may be worse than you think, especially if you are only counting patients who you see regularly or the ones that are doing well.  The patients who don’t come back need to be counted into adherence rates as well. Try changing your practice’s approach to improving the adherence rate for all patients.

2. Look into the causes of CPAP nonadherence and work to alleviate those issues

Find out what the biggest deterrents are to PAP adherence among your patients. We suggest that you even go as far as asking your patients for their feedback on what they can do to improve their PAP adherence.

Adherence is a multi-faceted issue, but many studies have suggested that the most common causes of low PAP tolerance are:

  • Ill-fitting PAP masks that cause discomfort
  • Lack of proper patient education

3. Remember that patient education is key to higher adherence rates

Patient education should start with the patient. Ideally, it would start with the patient realizing his or her symptoms of OSA, seeking medical help for a proper diagnosis and then understanding their treatment options.

It is important for sleep technologists and physicians to take the time to educate patients about their sleep disorder and provide the most appropriate testing to get the most accurate diagnosis.

Technologists must be knowledgeable about sleep disorders and treatment options.  For treatment of sleep disordered breathing technologists should be up to date on the latest PAP technology to offer the most appropriate durable medical equipment (DME) solutions from a provider staffed by experienced and qualified personnel that has an appropriate array of PAP devices and appliances available.

As technologists, every one of us should strive to make patient comfort and successful treatment a priority.

4. Make smart use of technology

Research if the equipment manufacturer has mobile apps that allow patients to review their data without physician involvement. Some patients might use an app to track their progress, which can be more convenient, less costly and ultimately more preferable for some patients.

5. Make sure your facility intervenes early to assure good outcomes

It might already be too late if your facility is not monitoring patients on PAP and intervening in the early treatment phase.  Usually, the first intervention is handled by a daytime sleep technologist who educates the patient about sleep apnea, has the patient try various interfaces, and employs comfort accessories, if needed. The chances are you’ll get better adherence rates the earlier you intervene with patients who are having difficulty with PAP therapy.

6. Up your patient touchpoints

Some of the most successful facilities have frequent patient touchpoints, where different staff members check-in with the patients to determine how their therapy is going.

There’s a reason why PAP therapy and adherence has become such a big issue within the sleep healthcare field. That’s because PAP therapy is an effective method for treating OSA, and the higher the adherence  rates are, the more patients we are keeping healthier because they are getting the treatment they need.

Did you know that the AAST has great resources on PAP adherence?

Make sure to download our Journal Club No. 37 article on PAP adherence, which is available at a discount to AAST members. 

Watch Julie's other presentation on OSA and PAP here.

Click on the button below to download our free module!

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About Kevin Asp

Because of the implementation of his best practices of Implementing Inbound Marketing in its Medical Practice, he turned the once stagnant online presence of Alaska Sleep Clinic to that of "The Most Trafficked Sleep Center Website in the World" in just 18 months time.

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