The application of new coverage determination adherence criteria for continued reimbursement of continuous positive airway pressure (CPAP) may have potential negative effects on patients with obstructive sleep apnea (OSA) and their clinical care. Adherence to therapy is defined as use of PAP > 4 hours per night on 70% of nights during a consecutive thirty (30) day period anytime during the first three months of initial usage.
Researchers from National Jewish Health in Denver retrospectively examined a database of 150 patients who received neuropsychological testing prior to CPAP treatment and 3 to 6 months post-treatment. Patients were categorized using the new coverage criteria, and comparisons were made between adherent and nonadherent groups on neuropsychological variables—55 patients (37%) failed to meet the new criteria; of the 63 patients who did not receive any special adherence intervention, 29 (46%) met the new criteria.
Researchers conclude that controlled trials are needed to better understand the effect of the new guidelines on adherence and treatment outcomes. This article is published in the October issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.