Management of continuous positive airway pressure treatment compliance using telemonitoring in obstructive sleep apnoea.
Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnoea (OSA), but treatment compliance is often unsatisfactory. This study investigated the efficacy and cost-effectiveness of telemonitoring for improving CPAP compliance.100 newly diagnosed OSA patients requiring CPAP (apnoea-hypopnoea index >15 events·h-1) were randomised to standard management or a telemonitoring programme that collected daily information about compliance, air leaks and residual respiratory events, and initiated patient contact to resolve issues. Clinical/anthropometric variables, daytime sleepiness and quality of life were recorded at baseline and after 3 months. Patient satisfaction, additional visits/calls, side-effects and total costs were assessed.There were no significant differences between the standard and telemedicine groups in terms of CPAP compliance (4.9±2.2versus5.1±2.1 h·night-1), symptoms, clinical variables, quality of life and unwanted effects. Telemedicine was less expensive than standard management (EUR123.65versusEUR170.97; p=0.022) and was cost-effective (incremental cost-effectiveness ratio EUR17 358.65 per quality-adjusted life-year gained). Overall patient satisfaction was high, but significantly more patients rated satisfaction as high/very high in the standard managementversustelemedicine group (96%versus74%; p=0.034).Telemonitoring did not improve CPAP treatment compliance and was associated with lower patient satisfaction. However, it was more cost-effective than traditional follow-up.
Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.|These authors are joint first authors and contributed equally to this work.
Cecilia
C
Turino
Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.|These authors are joint first authors and contributed equally to this work.
Jordi
J
de Batlle
Sleep and Ventilation Centre Blaubeuren, Respiratory Centre Ulm, Ulm, Germany.|ResMed Science Centre, ResMed Germany, Martinsried, Germany.
Holger
H
Woehrle
Oxigensalud, Barcelona, Spain.
Ana
A
Mayoral
Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.
Anabel Lourdes
0000-0002-3847-6261
AL
Castro-Grattoni
Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.
Sílvia
S
Gómez
Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.
Mireia
M
Dalmases
Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain sanchezdelatorre@gmail.com.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
Manuel
M
Sánchez-de-la-Torre
Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
Ferran
F
Barbé
D000328:Adult; D000368:Aged; D045422:Continuous Positive Airway Pressure / Q000191:economics; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D013030:Spain; D017216:Telemedicine / Q000191:economics; D016896:Treatment Outcome