Patients newly diagnosed with sleep apnea whose doctors have recommended pressure therapy have a right to be informed and knowledgeable about the medical device prescribed for them.
The physician - ideally in consultation with the patient -- writes a prescription for a particular type of pressure device and interface (mask, tubing, humidification, etc.). Most often, the prescription is filled by a durable medical equipment supplier. At this point, the patient (and consumer) needs instruction on the practical aspects of the specific machine and interface.
It is crucially important that this instruction come from an informed healthcare provider. The instructor does not necessarily need to be an MD, but it must be someone able both to set up the equipment and clearly explain how it is to be used and maintained.
Because of aggressive cost-containment practices, some insurers are arranging for the equipment to be shipped directly to patients, along with a centralized number for them to call to get answers to their questions. Sometimes an instructional video is included in the package.
The ASAA does not support the practice of "drop shipping" CPAP machines. It believes that better patient instruction results in better long-term compliance, which is in the best interest of the patients and the insurers. The cost of such instruction - which is should include information on how to obtain additional information and supplies - is minor compared to the benefits of successful CPAP therapy.
However, recognizing the constraints of the current healthcare system, the ASAA has come up with a set of recommendations for physicians and patients. In cases where the health insurance does not provide for patient instruction, the machine should be shipped to the prescribing physician. Alternatively, the patient can be told to bring the machine to the doctor's office. The physician can then verify the fit, address patient concerns, and reinforce the importance of the therapy. At the same time, this formal office visit makes it possible for the healthcare provider to be reimbursed for a complex consultation.
