Sunday, April 11, 2010

CPAP - Medical treatment compliance

Among the many things that makes it difficult to classify medicine as a science is the fact that many, if not most, medical treatments rely on patient compliance and have no trustworthy method for determining compliance level let alone enforcing compliance. Certainly there is the assumption that the patient will comply to achieve the maximum benefit or at least "get their money's worth".  But compliance is also affected by unpleasantness  of the treatment, loss of instructions or lack of understanding, embarrassment, non-belief or non-acceptance of the treatment, past experience or even hostility toward the practitioner, and just plain orneriness.


An example might be the respirator or CPAP machine I am currently using since I apparently have a severe case of sleep apnea.  Although I'm supposed to use the CPAP every night from the time I go to sleep until I get out of bed in the morning.  But I might take off the mask to go to the bathroom and forget to put it back on.  In the morning it might not remember anything about the incident.

My CPAP takes care of such problems and maintains a record of several key measurements allowing me or my treatment team to chart my progress or decline.  The simple top of machine readout gives an average for the past 7 days and past 25 days of the following: Therapy Hours; Days when therapy has exceeded 4 hours; Large leakage in the system; AHI (Apnea-Hypnopnea Index); Periodic breathing percentage; and 90% Pressure level.  There is a program costing $150 which will download data from the machine and produce reports like a real scientist would need. I feel that just tracking the read-out numbers would give a great amount of data.


The data is not only available in the readout window but also on an SD memory chip.  I would have appreciated having some instruction about logging this data or taking the memory chip in to the hospital for some analysis.  I'm concerned about whether I'm making any progress on the machine or even if I'm really using it right.
 

1 comment:

  1. Hmm..., you stated that you were concerned that you may not be using the CPAP right. Does that mean you haven't experienced much noticeable improvement? It may take awhile, but could you schedule an encounter with the respiratory therapist to ask your questions about readouts and proper fitting/utilization? You also mentioned in the past that you were always trying to lose weight at the beginning of the year and not showing much progress at the end of the year. Perhaps a more compelling reason for weight control would add to greater success at it?? Weight loss can improve sleep apnea--some are able to get off the CPAP machine with weight loss--others just find the machine works better. And different types of machines work better for some people than others, but I thought some of that determination was done in the initial sleep study when they woke you up to try a machine? Persue the reasons you are not getting the best results--this stuff is pretty important!

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