Meet your CPAP coach
YARMOUTH, Maine – There may be an app for everything these days, but with her background in nursing, Robyn Woidtke thinks there’s something to be said for the human touch.
“I’m the human app,” she said.
Woidtke, in conjunction with Sleep960, recently launched “Adherence by Alliance,” a program that offers three live coaching sessions by phone or through the Internet to help patients adapt to and live with sleep apnea. The sessions entail, among other things, assessing a patient’s readiness to change, developing a plan for adherence and reviewing successes and barriers. Details on the program can be found on her web site, CPAPcoach.com.
Here’s what Woidtke had to say about helping sleep apnea patients find their way.
HME News: You have a long list of credentials after your name: MSN, RN, RPSGT. How did you come to specialize in sleep apnea?
Robyn Woidtke: I actually started in the field in 1985 with high-risk infants, when there was no equipment available for them. We put them on home sleep apnea monitors. From there, I moved into more of a clinical coordinator role at the sleep disorder center at UC Irvine and then I moved into SIDS research at Stanford. After that, I moved into research for medical device companies, getting products through clinical trials and to market. But I felt I was missing my nursing roots.
HME: What is it about nursing that you missed?
Woidtke: I wanted to move back into an environment where I was helping patients on more of an individual level. One of my passions is moving past the technical side of things and moving toward the care coordinator side, and using behavioral theories to help direct care.
HME: Why is this type of care appropriate for sleep apnea patients?
Woidtke: There are multiple factors to adherence; it’s a very complex issue. It includes not only what the provider can give in terms of support, education and training, but also the patients’ abilities—their feeling of efficacy, and whether they have social support and financial support, and any co-morbidities.
HME: Where does the “Adherence by Alliance” program come in to play?
Woidtke: The goal is to provide that extra support and one-on-one guidance to help patients find their inner strength and motivation. Patients need to be empowered. They need to ask their healthcare providers, “Are you using an evidence-based practice in my care?” The Affordable Care Act is driving more patient accountability.
HME: You characterize your coaching as motivational interviewing.
Woidtke: The basis is motivational interviewing, and there’s evidence to support it. There was a study done in Australia of nurses who used motivational interviewing to improve adherence. Through different sessions with patients, they were able to demonstrate increased initial adherence and continued adherence throughout the course of the year.
HME: How do you help patients develop a plan to adapt to and live with sleep apnea?
Woidtke: It’s really driven by the patient’s needs. They direct the conversation. As a coach, I ask them open-ended questions, and I listen and listen and listen some more. By listening, you try to get out of them what their needs are and then help them to develop a plan.
HME: There seems to be a growing effort among a growing number of stakeholders to help sleep apnea patients. Why?
Woidtke: I think it’s about outcomes. I think third-party payers and CMS—you’re already seeing them say, “You have to demonstrate benefit, i.e. improved outcomes, quality of life, reduction in blood pressure, improved cognitive abilities.” We’re seeing more pay for performance.
HME: You said that sleep apnea patients often feel chastised by their providers. What should be the role of the HME provider?
Woidtke: Maybe there’s some shared cost between the patient and the provider. The provider also has an incentive to get patients adherent, in terms of the resupply of masks, hoses, etc. This is obviously not a service that everyone can afford to use or needs to use, but for patients experiencing difficulty, it works. Sometimes people just need to talk to people, and providers may be too busy, whether it’s an HME provider, a doctor or a nurse. Sometimes people feel lost.