CPAP Adherence Survey -- Patient feedback requested

We are excited to develop a new survey assessing what many of you have identified as a key issue for patients - CPAP Adherence. Please take a moment to review the questions that we have pulled together and let us know if any important issues are missing from the survey. During your review, please keep in mind that for many of the questions we will need to provide answer choices for the survey respondent rather than have patients write in or explain their answers. This is often called “free text” in survey jargon and it is very difficult and time intensive to interpret these types of answers.

The goal is to keep the survey under 10 questions, similar to the current set of surveys available on the site.

View the survey draft

Thanks for sharing your thoughts on the matter!

Hi mrueschman,

Thanks for asking for feedback. I have just returned from vacation and I am getting caught up.

I think the survey asks some valuable questions and gives a good range of responses.

I can think of a couple of additional questions that might provide helpful information.

1. How long has the person been using CPAP? Reason for question....I suspect that the highest drop out rate happens in the first 3 months. If that where the dropout occurs, then strategies can be tailored towards new users.

2. If you have stopped using CPAP, what is the major reason?

   • could not find a comfortable fit
   • could not afford to purchase alternative masks / supplies, if initial did not work
   • did not know how to resolve problems, eg pressure sores, skin irritation, swallowing air, mask leaking air, sore nose, dry mouth, etc.
   • did not seem worth the hassle
   • did not feel any better when using CPAP,etc. I think it would be worthwhile to know what led to abandoning CPAP

Just my thoughts. I don't think paying someone to be compliant will be enough of a motivator. However, I think the gift card giveaway on this site is a nice incentive to participate, since it allows a person to purchase supplies and accessories that they might not otherwise be able to afford.

Thanks for asking

Thanks for your input, @2Sleepy

I agree about the importance of your suggested questions -- trying to get at length of overall CPAP use and the major reason(s) why someone has stopped using CPAP. I will share with the team to discuss the possible incorporation of such questions.

Those are great suggestions for inclusion in the survey. What is the reasoning behind the two hypothetical questions? Questions like these can be problems as people tend to over-look the "hypothetical" and only remember that they might be charged for not using their CPAP or that they might get money for using it. I don't see where either scenario might happen and think that the questions might cause a lot of confusion.

I like the survey questions. Perhaps another way to ask the hours/night question might be to ask what percentage of the night do you sleep using your CPAP? Alternatively, "On average, how many hours do you sleep per night using your CPAP", and also "how many hours per night do you sleep without your CPAP"

I see no purpose in the following question and it gave me a knee jerk when I read it. It could detour someone from continuing the survery. Otherwise, I like all the other questions and think they cover the issues.

1. Please consider this hypothetical situation. Suppose your health care provider decides to charge a monthly fee to patients who do not use their CPAP for at least 4 hours per night. How much do you think is a reasonable fee to be charged for not using CPAP?

   1. Why do you use CPAP? Check all that apply. I home to improve my other health problems (e.g. high blood pressure) by using CPAP --Should say :hope

To me the 'tone' of this survey is that the respondent is likely not to be compliant in use of the CPAP.

I think that the second question asking about hours of use over the last month, when using a CPAP, is problematical. Isn't the real question whether the individual used the CPAP for the entire sleep duration or not? For example if I had a busy month and only slept for 5 hours a night (average) for a month and chose 5 hours as the answer would the researcher then conclude that I took the mask off and then went back to sleep? Is question 3 intended to cover that situation?

I might be missing something here but if the survey is not really interested in how long one sleeps at night then possibly the following could be used for questions 3 and 4:

When I use the CPAP:

• I typically use it until I get up.
• I typically take it off prior to getting up.

I you do take CPAP off prior to finishing your sleep what best describes how you use your CPAP: *I normally take it off after a fixed amount of time (such as 3, 4, or 5 hours).

• I normally take if off if I wake up during the night.
• (I can't think of other response choices which probably means that I did not get a good night's sleep last night).

Question 4 (provider charges for non-use) almost makes my blood boil. We can get into a discussion about that if you wish.

Question 5 is interesting. Where is that money coming from? I doubt that the insurance company would be willing to allow that as a charge. If that indeed is the case then the patient is paying that money.

Question 6, bullet 8 should probably be "I hope to..." rather than "I home to..."

Question 7, you might want to include just being curious how well you sleep without it as a possible response.

Question 8 seems to assume that a person is not compliant. In the couple of years that I have had a CPAP machine there are probably only about 15 days total that I have not worn the mask all night. Two times because of facial irritation and maybe four times just to see how I slept without it (the other 9 times, travelling and its use was not convenient). When using it, I have never not used it for the entire duration of my sleep.