Class, I added an additional blog to our list regarding CPAP compliance.
http://c-pap.blogspot.com/
I would like to address the importance of medical (non)compliance generally. CPAP is a therapy for people with a condition called sleep apnea. It is likely that the great majority of people who have this condition do not know that they have it. The most common evidence of it is snoring during sleep. The airway in the back of the mouth becomes obstructed as the muscles relax during sleep. The blockage causes a drop in oxygen in the blood which alerts the brain to a crisis. The brain command the body to respond to the crisis. The heart has to crank up quickly. The person does not usually wake up, but this can happen hundreds of times during a night. This is very hard on the heart. It messes up the quality of sleep. The long-term medical consequences can be serious.
Like so many conditions today, we have a way to address this chronic condition. It involves sleeping with a machine running that pumps air under pressure to a mask worn by the patient. This can be very annoying. Rates of medical noncompliance are high. It is important that people who need this use the equipment every night. The consequences of not using the equipment are high both for individuals and for society. The consequences of noncompliance are not just medical. They are also financial.
Physicians, hospitals and other medical providers have an obligation to try to improve rates of medical compliance regarding a great variety of things. Patient education is key. Social support is key. But I don't think insurance plans (or government payment systems) reward providers for the time and effort required to increase rates of compliance. Many patients with chronic conditions are relatively uneducated or elderly. Many live alone. This is a social challenge -- not "just" a medical challenge. How can we encourage people to do what they know they should do? How can we help people who do not understand what needs to be done and why? I don't know. But I am quite sure that approaches grounded in fear are not likely to be successful. People will block the message to avoid the fear. And not everyone responds well to a reasoned argument. I don't know, but this is important.
I agree, medical noncompliance is very costly, health wise and financially. As you stated in your blog, patient education is the key; for those individuals whom are unaware of the importance, individuals that are unsure or take what they are suppose to do or even the equipment for granted, and for those individuals who simply don’t know. Nine times out of ten, Ignorance is the cause of medical noncompliance. I also agree with you when you said “people will block the message to avoid the fear.” This is a very true statement….we as a society need to start grasping the message versus blocking it, in order to help us conquer the fear.
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