Improvements in compliance
The assessment and evaluation of this new device showed that all patients were clearly positive about the valve used for digital occlusion of the device, and thus the stoma.9 Voicing was considerably facilitated and the intelligibility improved. The HME cassette could easily be replaced manually, if needed. The median period of time that the adhesive adhered to the skin optimally was one day for the regular adhesive and two days for the other two types of adhesive. Problems experienced in previous studies related to the adhesive tape, such as skin irritation, inadequate adherence and loosening of the plaster by coughing or forced expectoration in order to clear the airway could be solved by the availability of the different adhesives included in this system. For each individual patient a suitable plaster was available. The fact that these plasters did correctly adhere to the skin for often more than one day was appreciated by most patients.It could be concluded from our initial study, there was a clear improvement in short-term compliance. In order to investigate long-term compliance, 69 consecutive patients were interviewed by means of a structured questionnaire.10 The results showed that all patients expressed their satisfaction with the valve used for digital occlusion of the stoma. Sixty-three percent of the patients reported that voicing was facilitated. Subjective intelligibility improved in 55% of the patients. Previous problems with other devices, e.g. plaster adherence, skin irritation, and handling were clearly diminished, increasing the long-term compliance of the patients to 78%.