Managing your patients fortonight and the long-term
Your image and perception ◦ Instilled trust Actions speak a thousand words Use props, posters and materials Understand your influence Features of today‟s PAP ◦ Know what your doc prescribes Sleep hygiene and gimmicks
Instructing behavior to affect your patients Few consistencies in research ◦ Patients feel “closed in” ◦ Disease, age, pressure unrelated Using theory and your experience ◦ Develop consistent strategy Practice your interactions ◦ Most patients have similar concerns Make yourself available
Key concepts and Principles ◦ Develop Discrepancy Help patient understand their choices with PAP and risks without ◦ Express Empathy Avoid being pulled into a debate about PAP ◦ Expect Resistance Ever meet a happy PSG or titration patient? ◦ Support “Most people take a while to adjust to CPAP and to build the use of it into their daily lives”
Consequences of OSA are real ◦ Daytime sleepiness ◦ Mood changes ◦ Depression ◦ Irritability ◦ Impairment in attention, concentration & memory Effective Therapy time is… ◦ 4.5 Hours Despite it‟s efficacy, 25% of patients discontinue use during the first year.
Conclusion: “Self confidence appeared to be the strongest single psychological predictor of long-term adherence. Behavior change constructs are among the strongest predictors of PAP adherence in the literature to date.” ◦ Brief behavioral Therapies reduce Early PAP Discontinuation Rates in SAS: Preliminary findings
Manufacturers CEU Monographs Professional Societies Trade Journals Networking events Home Testing
We asked a few of our veteran clinicians about what they‟d like to convey to patients at their PSG and titration studies. It‟s interesting what we found. What do you think they said?
Educate their patients more on the reasons they‟re using PAP.
Do you know much about sleep apnea? Are you nervous? When was your last good night of sleep? What are you doing tomorrow?
Explain in layman‟s terms. ◦ Often, the side effects of apnea affect patient understanding Patients need patience ◦ PAP has a period of adjustment Focus on reality ◦ Explain the mechanics of an air splint ◦ Educate on why PAP works and co-morbidities Empathize Encourage contact with home care company“Imagine if you had never worn a pair of shoes. With your firstpair, you gradually get used to them but they can cause pain andblisters. However, you can‟t just fix it by changing the pair of shoescontinuously."
“I hear the word „suffocated‟ a lot” ◦ Exhaling and mechanics of the PAP Practice during the day ◦ 30 minute increments ◦ With mask, with PAP Educate on variable adjustment period ◦ Time frames with CMS patients „Walk‟ patient through prior to titration ◦ What will happen Humidity ◦ Comfort ◦ Season
Often receive therapy quicker More benefit Tolerance for medical care Do you agree?