One-on-one time improves CPAP compliance, research finds

Tuesday, October 23, 2012

ATLANTA – Two-and-a-half hours of contact time between patients and respiratory therapists (RTs) within the first 30 days of using CPAP devices increases compliance, according to new research.

Researchers from Kaiser Permanente, who will present their findings this week at CHEST 2012, retrospectively reviewed the charts of 39 patients with obstructive sleep apnea (OSA) who used CPAP devices and who used a portable compliance-monitoring device. These patients had one-on-one meetings with RTs three times for a total of 150 minutes. On day 30, a 30-minute compliance evaluation review was conducted, and data was downloaded from the CPAP devices.

“Results showed a 75% CPAP compliance rate after 30 days,” stated a summary of the presentation on the website of the American College of Chest Physicians, which hosts CHEST.

An abstract of the findings will be published in an online supplement of the CHEST Journal.


I have been in the DME industry for more than 7 years and have focused exclusively on sleep for the past 5 years.  I'm certainly not surprised by the compliance data and am proud to say that 30-day compliance for my patients averages at 69.2%, including the outliers.  What is frustrating is that the RT time spent with a new PAP patient is not reimbursable; in fact, RT reimbursment across the board - hospitals, offices and clinics - is being cut.  Physicians and labs are growing in the expectation that the DME supplier is responsible for education, follow up and compliance in the face of massive cuts and the debacle known as competitive bidding.  Spending 2.5 professional hours with a patient deserves remuneration.  Where is the AARC spending my dues?  It appears not to be in lobbying for my profession.

Basically I second the motion presented by  tonicacioppo on 11/06/2012.

How easy is to publish the benefits of 2.5 hours of contact between our CPAP patients and our therapists, but to omit adding that insurance companies should consider reimbursing DME companies for that time.

How convenient it is to proposed that DME companies expend 2.5 hours of free time per patient, instructing patients to improve compliance, when the same doctors are grouping around the idea of dispensing DME equipment directly to their patients? What about conflict of interest? Could we not see the hands of insurance companies behind this two motions?.

I agree with  tonicaciopp, once again we are able to see that  our membership dues are been used for motives other than our own interest, perhaps we should consider redirecting our professional dues.  

Speaking as an RT that has been in the industry since 1981, RT's have always gotten the short end of the stick, regarding reimbursement. Whether it be in hospitals or the home care field, we have never been paid for our expertise as cardiopulmonary specialists. We are, most of the time, considered the low people on the totem pole, the ones who do the neb tx's and incentive spirometrys or vent tubing changers. We have never received the respect, as a profession, that we so truely deserve. When I ventured into the home care market, I wanted to make a difference, as a therapist, to ensure that my patients were receiving the best instruction and equipment so that i could greatly improve their outcomes and quality of life. And I have done so. And yet, unless you have a home ventilator patient, there is no reimbursement for my professional time spent educating and caring for my home COPD or OSA patients. As one who got to sit in when the Texas Dept of Health was forming the RCP licensure, I was so expectant that "THIS" would make a difference and would ensure respect, and hand-in-hand, better reimbursement for our profession. And yet, here we are 30 yrs later and home health aids, God bless them and all they do, are reimbursed through payors and we are not.

So yes, I believe the AARC has drastically dropped the ball. We should be recognized. Licensed RT's are required, by guidelines, to perform the clinical tasks. AARC please be our voice. Here again is your chance.

The Nose Cozy has changed the way out patients use their cpap machines. Our therapists once complained the patients were not comfortable. They complained of pain the experienced on the bridge of the nose and some patients refused to wear their full-face mask. Insurance companies were refusing to pay for unused machines and we had a real issue on our hands. A sales representative met with us and shared some awesome data on a new product called the Nose Cozy. We purchased a modest amount and our patients, eager for relief, bought all we had. I suggest this product to other home care companies who are having difficulty getting payment for unused cpap machines. Patients say it beats other nasal pillows because it is soft, helps create the perfect seal every time and doesn't stink. The therapists suggest this product and compliance soared. We didn't want to keep this to ourselves but share this so other small home care companies no longer have to deal with unruly patients and unpaid invoices!