RT Journal Article
SR Electronic
T1 A Bayesian cost-effectiveness analysis of a telemedicine-based strategy for the management of sleep apnoea: a multicentre randomised controlled trial
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 1054
OP 1061
DO 10.1136/thoraxjnl-2015-207032
VO 70
IS 11
A1 Valentina Isetta
A1 Miguel A Negrín
A1 Carmen Monasterio
A1 Juan F Masa
A1 Nuria Feu
A1 Ainhoa Álvarez
A1 Francisco Campos-Rodriguez
A1 Concepción Ruiz
A1 Jorge Abad
A1 Francisco J Vázquez-Polo
A1 Ramon Farré
A1 Marina Galdeano
A1 Patricia Lloberes
A1 Cristina Embid
A1 Mónica de la Peña
A1 Javier Puertas
A1 Mireia Dalmases
A1 Neus Salord
A1 Jaime Corral
A1 Bernabé Jurado
A1 Carmen León
A1 Carlos Egea
A1 Aida Muñoz
A1 Olga Parra
A1 Roser Cambrodi
A1 María Martel-Escobar
A1 Meritxell Arqué
A1 Josep M Montserrat
A1 the SPANISH SLEEP NETWORK
YR 2015
UL http://thorax.bmj.com/content/70/11/1054.abstract
AB Background Compliance with continuous positive airway pressure (CPAP) therapy is essential in patients with obstructive sleep apnoea (OSA), but adequate control is not always possible. This is clinically important because CPAP can reverse the morbidity and mortality associated with OSA. Telemedicine, with support provided via a web platform and video conferences, could represent a cost-effective alternative to standard care management.Aim To assess the telemedicine impact on treatment compliance, cost-effectiveness and improvement in quality of life (QoL) when compared with traditional face-to-face follow-up.Methods A randomised controlled trial was performed to compare a telemedicine-based CPAP follow-up strategy with standard face-to-face management. Consecutive OSA patients requiring CPAP treatment, with sufficient internet skills and who agreed to participate, were enrolled. They were followed-up at 1, 3 and 6 months and answered surveys about sleep, CPAP side effects and lifestyle. We compared CPAP compliance, cost-effectiveness and QoL between the beginning and the end of the study. A Bayesian cost-effectiveness analysis with non-informative priors was performed.Results We randomised 139 patients. At 6 months, we found similar levels of CPAP compliance, and improved daytime sleepiness, QoL, side effects and degree of satisfaction in both groups. Despite requiring more visits, the telemedicine group was more cost-effective: costs were lower and differences in effectiveness were not relevant.Conclusions A telemedicine-based strategy for the follow-up of CPAP treatment in patients with OSA was as effective as standard hospital-based care in terms of CPAP compliance and symptom improvement, with comparable side effects and satisfaction rates. The telemedicine-based strategy had lower total costs due to savings on transport and less lost productivity (indirect costs).Trial register number NCT01716676.