Apria’s new study lays CPAP debate to rest

COSTA MESA, Calif. - Patients who are set-up on sleep therapy equipment in an Apria CPAP Center are achieving high rates of acceptance and compliance, according to a new study that involved more than 1,300 patients. The results of the Apria Healthcare study, conducted between January 2000 and July 2003, found that 87% of patients who received education in a group setting at an Apria Center were using CPAP for 6.5 hours for two to three weeks after the set up. Nearly four out of five patients reported that that their mask was still comfortable during the follow-up call and nine out of 10 found they did not require a mask refit. Four out of five reported that CPAP had improved their condition and slightly more than seven out of 10 reported no skin problems. No definitive benchmarks exist to contrast against patients set-up in the home, but the anecdotal evidence suggests that the clinical setting is the way to go. “Our competitors have said things like, ‘Apria won't go to the home to do set-ups,'” said Vernon Pertelle, Apria's national respiratory manager. “But the bottom line is it's just not the best setting. The phone rings, the dog barks, family members interrupt and the level of retention does not occur.” The study justifies a decision Apria made about five years ago that required most of its CPAP patients to come in to branch locations for set-up instruction. Although the decision was driven by reimbursement pressures, the collateral benefit of improved patient outcomes has been a happy by-product. Houston-based Health Management Services (HMS), which today serves 35,000 patients in six states, echoes Pertelle's plaudits for office set-up. “We can present a much better learning experience in the clinical setting - no TVs, no kids, no dogs,” said John Goodman, president of HMS. HMS started calling patients in for CPAP set-up in 1995. Today, nine out of 10 patients are educated on-site. What Apria, nor any provider would doubt, is the cost efficiencies gained by pulling your patients into the office for education. While an RT can handle a whole class of new CPAP patients in the office, the average RT can only make five in-home visits to do CPAP set-ups in a single day, according to a 2002 AAHomecare study.