Insurance coverage policies define the diagnostic criteria and adherence requirements for patients to qualify for initial and ongoing therapy with continuous positive airway pressure (CPAP) treatment, the most complete therapy for obstructive sleep apnea. Unfortunately, a number of patients who use CPAP and benefit from treatment fail to meet these requirements. We present 15 patients who fail to meet Centers for Medicare and Medicaid Services' (CMS) criteria, highlighting policies that do not support patient care. Finally, we review expert panel recommendations to improve CMS policies, and we suggest ways that physicians can better support CPAP access within the current regulatory restrictions.
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http://dx.doi.org/10.1212/CPJ.0000000000200118 | DOI Listing |
Pulm Ther
January 2025
US Medical Affairs, GSK, ATC Fowler Building, 410 Blackwell Street, Durham, NC, 27701, USA.
Introduction: Escalation to single- or multiple-inhaler triple therapy (SITT; MITT) is a recommended option for patients with asthma who remain uncontrolled by medium-dose inhaled corticosteroid/long-acting β-agonist; however, characterization of elderly users of triple therapy is limited. This real-world cohort study describes demographics and clinical characteristics of elderly patients with asthma with and without comorbid chronic obstructive pulmonary disease (COPD) who are new users of triple therapy, and asthma treatment patterns preceding triple therapy initiation.
Methods: This retrospective cohort study used administrative claims data from the Optum Clinformatics Data Mart database.
Sleep Breath
January 2025
Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, John Paul II Hospital, Prądnicka 80, Kraków, 31-202, Poland.
Background: Obstructive sleep apnoea (OSA) may lead to heart rhythm abnormalities including bradycardia. Our aim was to ascertain clinical and echocardiographic parameters in patients with OSA in whom severe bradycardia was detected in an outpatient setting, as well as to evaluate the efficacy of CPAP therapy on heart rate normalization at the early stages of treatment.
Methods: Fifteen patients mild, moderate or severe OSA and concomitant bradycardia were enrolled.
Pediatr Pulmonol
January 2025
Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 59 Boulevard Pinel, Lyon, France.
Background: New CFTR Modulator triple therapy Elexacaftor-Ivacaftor-Tezacaftor (ETI) prove efficacy in pulmonary outcomes. However, its impact on nasal sinus symptoms in children has not been specifically studied. The aim of this study is to evaluate the impact of this therapy on nasal sinus symptomatology in children aged 6-12 years.
View Article and Find Full Text PDFRadiol Case Rep
March 2025
Department of Radiology, Makassed hospital, Jerusalem, Palestine.
Zinner syndrome (ZS) is a rare congenital urological condition characterized by a triad of ipsilateral seminal vesicle cysts, unilateral renal agenesis, and ejaculatory duct obstruction, first described in 1914. This case report details the presentation and management of a 27-year-old male diagnosed with ZS following a 2-month history of urinary frequency, hesitancy, dysuria, and painful ejaculation. Physical examination revealed a left lower abdominal mass, and imaging confirmed the classic findings of ZS, including unilateral renal agenesis, an enlarged seminal vesicle cyst, and an ectopic ureter.
View Article and Find Full Text PDFInt J Chron Obstruct Pulmon Dis
January 2025
School of Translational Medicine, Monash University, Melbourne, VIC, Australia.
Purpose: Oral corticosteroids (OCS) are recommended for the treatment of exacerbations in people with COPD; however, high cumulative lifetime doses (≥1000mg prednisolone-equivalent) are associated with adverse health effects. This issue is well defined in asthma but is less well understood in COPD. The aim of this study was to examine cumulative OCS dispensed to people with COPD over 12 months.
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