A Bayesian cost-effectiveness analysis of a telemedicine-based strategy for the management of sleep apnoea: a multicentre randomised controlled trial

Autor: Isetta, Valentina, Negrín, Miguel A., Monasterio Ponsa, Carmen, Masa, Juan F., Feu, Nuria, Álvarez, Ainhoa, Campos Rodríguez, Francisco, Ruiz, Concepción, Abad, Jorge, Vázquez-Polo, Francisco J., Farré Ventura, Ramon, Galdeano Lozano, Marina, Lloberes, Patricia, Embid, Cristina, Peña, Mónica de la, Puertas, Javier, Dalmases Cleries, Mireia, Salord, Neus, Corral, Jaime, Jurado, Bernabé, León, Carmen, Egea, Carlos, Muñoz, Aida, Parra Ordaz, Olga, Cambrodi, Roser, Martel-Escobar, María, Arqué, Meritxell, Montserrat Canal, José Ma., Spanish Sleep Network
Přispěvatelé: Universitat de Barcelona
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Pulmonary and Respiratory Medicine
Male
Telemedicine
medicine.medical_specialty
Epidemiology
medicine.medical_treatment
Cost-Benefit Analysis
law.invention
Indirect costs
Clinical trials
Quality of life
Randomized controlled trial
law
medicine
Humans
Continuous positive airway pressure
Prospective Studies
Disease management (health)
Epidemiologia
Telecommunication in medicine
Sleep apnea syndromes
Primary health care
Sleep Apnea
Obstructive
Continuous Positive Airway Pressure
business.industry
Disease Management
Bayes Theorem
Cost-effectiveness analysis
Síndromes d'apnea del son
Middle Aged
nervous system diseases
respiratory tract diseases
Clinical trial
Atenció primària
Physical therapy
Quality of Life
Patient Compliance
Female
business
Sleep
Follow-Up Studies
Telecomunicació en medicina
Assaigs clínics
Zdroj: Dipòsit Digital de la UB
Universidad de Barcelona
Europe PubMed Central
Recercat. Dipósit de la Recerca de Catalunya
instname
Popis: 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.
Databáze: OpenAIRE
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