Industry on CPAP adherence: We told you so

Tuesday, November 23, 2010

DENVER - A new scientific study that says Medicare guidelines for CPAP therapy could be interfering with patient adherence echoes the industry's concerns.

"We continually hear from providers that this is a problem," said Kelly Riley, director of the National Respiratory Network and chairwoman of AAHomecare's CPAP Task Force.

For the study, published in the October issue of Chest, researchers from National Jewish Health in Denver examined 150 patients who received psychological testing prior to CPAP treatment and three to six months post-treatment. They found 37% of those patients failed to meet the new criteria, and of 63 other patients who did not receive any special adherence intervention, only 46% met the criteria.

The guidelines, which went into effect in November 2008, stipulate that for Medicare to continue paying for a CPAP after the first 90 days of therapy, patients must be using the equipment at least four hours per night on 70% of nights during a consecutive 30-day period.

That's often not enough time to get used to the therapy, says Riley.

"It's the adaptation to a significant lifestyle change," she said. "Everything from pressure in the airway to rolling over and knocking against the tubing. (Getting used to that) doesn't happen overnight."

Medicare's CPAP policy is a short-sighted way to save money, said Bob McCoy, managing director of Valley Inspired Products.

"CMS is practicing economics, not medicine," he said. "We need to document the consequences of them mandating a certain way of doing things to see what the true cost is of ineffective therapy."