Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial

Introduction: Obstructive sleep apnea (OSA) is a prevalent disease associated with significant morbidity and high healthcare costs. Information and communication technology could offer cost-effective management options. Objectives: To evaluate an out-of-hospital Virtual Sleep Unit (VSU) based on tel...

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Autores: Lugo, Vera M., Garmendia, Onintza, Suarez Girón, Monique, Torres, Marta, Vázquez Polo, Francisco J., Negrín, Miguel A., Moraleda, Anabel, Roman, Mariana, Puig, Marta, Ruiz, Concepción, Egea, Carlos, Masa, Juan F., Farré Ventura, Ramon, Montserrat Canal, José Ma.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/175412
Acceso en línea:https://hdl.handle.net/2445/175412
Access Level:acceso abierto
Palabra clave:Síndromes d'apnea del son
Qualitat de vida
Telecomunicació en medicina
Sleep apnea syndromes
Quality of life
Telecommunication in medicine
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spelling Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trialLugo, Vera M.Garmendia, OnintzaSuarez Girón, MoniqueTorres, MartaVázquez Polo, Francisco J.Negrín, Miguel A.Moraleda, AnabelRoman, MarianaPuig, MartaRuiz, ConcepciónEgea, CarlosMasa, Juan F.Farré Ventura, RamonMontserrat Canal, José Ma.Síndromes d'apnea del sonQualitat de vidaTelecomunicació en medicinaSleep apnea syndromesQuality of lifeTelecommunication in medicineIntroduction: Obstructive sleep apnea (OSA) is a prevalent disease associated with significant morbidity and high healthcare costs. Information and communication technology could offer cost-effective management options. Objectives: To evaluate an out-of-hospital Virtual Sleep Unit (VSU) based on telemedicine to manage all patients with suspected OSA, including those with and without continuous positive airway pressure (CPAP) therapy.Methods: This was an open randomized controlled trial. Patients with suspected OSA were randomized to hospital routine (HR) or VSU groups to compare the clinical improvement and cost-effectiveness in a non-inferiority analysis. Improvement was assessed by changes in the Quebec Sleep Questionnaire (QSQ), EuroQol (EQ-5D and EQ-VAS), and Epworth Sleepiness Scale (ESS). The follow-up was 3 months. Cost-effectiveness was assessed by a Bayesian analysis based on quality-adjusted life-years (QALYs).Results: The HR group (n: 92; 78% OSA, 57% CPAP) compared with the VSU group (n: 94; 83% OSA, 43% CPAP) showed: CPAP compliance was similar in both groups, the QSQ social interactions domain improved significantly more in the HR group whereas the EQ-VAS improved more in the VSU group. Total and OSA-related costs were lower in the VSU group than the HR. The Bayesian cost-effectiveness analysis showed that VSU was cost-effective for a wide range of willingness to pay for QALYs. Conclusions: The VSU offered a cost-effective means of improving QALYs than HR. However, the assessment of its clinical improvement was influenced by the choice of the questionnaire; hence, additional measurements of clinical improvement are needed. Our findings indicate that VSU could help with the management of many patients, irrespective of CPAP use.Public Library of Science (PLoS)2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/175412Articles publicats en revistes (Biomedicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1371/journal.pone.0224069PLoS One, 2019, vol. 14, num. 10, p. e0224069https://doi.org/10.1371/journal.pone.0224069cc-by (c) Lugo, Vera M. et al., 2019http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1754122026-05-27T06:46:51Z
dc.title.none.fl_str_mv Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial
title Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial
spellingShingle Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial
Lugo, Vera M.
Síndromes d'apnea del son
Qualitat de vida
Telecomunicació en medicina
Sleep apnea syndromes
Quality of life
Telecommunication in medicine
title_short Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial
title_full Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial
title_fullStr Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial
title_full_unstemmed Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial
title_sort Comprehensive management of obstructive sleep apnea by telemedicine: Clinical improvement and cost-effectiveness of a Virtual Sleep Unit. A randomized controlled trial
dc.creator.none.fl_str_mv Lugo, Vera M.
Garmendia, Onintza
Suarez Girón, Monique
Torres, Marta
Vázquez Polo, Francisco J.
Negrín, Miguel A.
Moraleda, Anabel
Roman, Mariana
Puig, Marta
Ruiz, Concepción
Egea, Carlos
Masa, Juan F.
Farré Ventura, Ramon
Montserrat Canal, José Ma.
author Lugo, Vera M.
author_facet Lugo, Vera M.
Garmendia, Onintza
Suarez Girón, Monique
Torres, Marta
Vázquez Polo, Francisco J.
Negrín, Miguel A.
Moraleda, Anabel
Roman, Mariana
Puig, Marta
Ruiz, Concepción
Egea, Carlos
Masa, Juan F.
Farré Ventura, Ramon
Montserrat Canal, José Ma.
author_role author
author2 Garmendia, Onintza
Suarez Girón, Monique
Torres, Marta
Vázquez Polo, Francisco J.
Negrín, Miguel A.
Moraleda, Anabel
Roman, Mariana
Puig, Marta
Ruiz, Concepción
Egea, Carlos
Masa, Juan F.
Farré Ventura, Ramon
Montserrat Canal, José Ma.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Síndromes d'apnea del son
Qualitat de vida
Telecomunicació en medicina
Sleep apnea syndromes
Quality of life
Telecommunication in medicine
topic Síndromes d'apnea del son
Qualitat de vida
Telecomunicació en medicina
Sleep apnea syndromes
Quality of life
Telecommunication in medicine
description Introduction: Obstructive sleep apnea (OSA) is a prevalent disease associated with significant morbidity and high healthcare costs. Information and communication technology could offer cost-effective management options. Objectives: To evaluate an out-of-hospital Virtual Sleep Unit (VSU) based on telemedicine to manage all patients with suspected OSA, including those with and without continuous positive airway pressure (CPAP) therapy.Methods: This was an open randomized controlled trial. Patients with suspected OSA were randomized to hospital routine (HR) or VSU groups to compare the clinical improvement and cost-effectiveness in a non-inferiority analysis. Improvement was assessed by changes in the Quebec Sleep Questionnaire (QSQ), EuroQol (EQ-5D and EQ-VAS), and Epworth Sleepiness Scale (ESS). The follow-up was 3 months. Cost-effectiveness was assessed by a Bayesian analysis based on quality-adjusted life-years (QALYs).Results: The HR group (n: 92; 78% OSA, 57% CPAP) compared with the VSU group (n: 94; 83% OSA, 43% CPAP) showed: CPAP compliance was similar in both groups, the QSQ social interactions domain improved significantly more in the HR group whereas the EQ-VAS improved more in the VSU group. Total and OSA-related costs were lower in the VSU group than the HR. The Bayesian cost-effectiveness analysis showed that VSU was cost-effective for a wide range of willingness to pay for QALYs. Conclusions: The VSU offered a cost-effective means of improving QALYs than HR. However, the assessment of its clinical improvement was influenced by the choice of the questionnaire; hence, additional measurements of clinical improvement are needed. Our findings indicate that VSU could help with the management of many patients, irrespective of CPAP use.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/175412
url https://hdl.handle.net/2445/175412
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0224069
PLoS One, 2019, vol. 14, num. 10, p. e0224069
https://doi.org/10.1371/journal.pone.0224069
dc.rights.none.fl_str_mv cc-by (c) Lugo, Vera M. et al., 2019
http://creativecommons.org/licenses/by/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Lugo, Vera M. et al., 2019
http://creativecommons.org/licenses/by/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv Articles publicats en revistes (Biomedicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301629

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