Abstract
Many patients and many physicians do not appreciate the health ramifications of sleep apnea or the economic impact of low treatment rates. Placing this information in an easily and repeatedly accessible form can have many benefits including education, personal relevance for those affected with CPAP compliance difficulties. Patient education can have long term positive impact of patient outcome. For example, a single enhanced patient education session delayed initiation of dialysis by 4.6 months (Devins et al., 1993). The objective of this study was to determine the association between patient education and CPAP compliance. 200 consecutive patients of an urban sleep clinic and 200 consecutive patients in a small rural facility were enrolled in the study. 100 patients in each location received the standard consultation with their physicians after the diagnosis of obstructive sleep apnea before receiving their CPAP machine. The other 100 patients in each location received an educational booklet (Sleep Apnea, CPAP and Me by Shapiro G, Zalai, D. Trajanovic N, & Mallea, J) on sleep apnea in addition to the standard consultation with their doctors. All patients had a one month and a one year follow up follow up with the consultant. CPAP compliance was assessed at the one year follow up visit. Compliance was defined as a regular CPAP use five or more nights per week and a minimum of 5 h each night. At one year follow-up 75% patients in the standard consultation group in the urban location were compliant CPAP users. The compliance rate of patients who received the booklet in addition to the consultation was 87% at follow up. There was a significant association between the receiving the booklet and CPAP compliance ( ÷ 2 = 4.68, p < .05) in this group. In the rural location the compliance rate of 89% in the special education group was not significantly higher than the compliance rate of 82% in the control group. Education clearly helps but this may be less so in an already highly compliant group. In a review we have previously showed very high compliance rates at the rural center. There may be several reasons for this and these should be explored. On the basis of “Bang for Buck” the provision of this $10 booklet appears to be valuable and has become a pattern for a number of CPAP suppliers when so asked by physicians running a sleep clinic. At this point in time there is the need to translate the book into other languages. Any takers?
Published Version
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