Management of continuous positive airway pressure treatment compliance using telemonitoring in obstructive sleep apnoea

[摘要] 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 (apnoeaxe2x80x93hypopnoea index >15xe2x80x85eventsxc2xb7hxe2x88x921) 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 3xe2x80x85months. 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 (4.9xc2xb12.2 versus 5.1xc2xb12.1xe2x80x85hxc2xb7nightxe2x88x921); symptoms; clinical variables; quality of life and unwanted effects. Telemedicine was less expensive than standard management (EUR123.65 versus EUR170.97; p=0.022) and was cost-effective (incremental cost-effectiveness ratio EUR17xe2x80x8a358.65 per quality-adjusted life-year gained). Overall patient satisfaction was high; but significantly more patients rated satisfaction as high/very high in the standard management versus telemedicine group (96% versus 74%; 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.

[学科分类] 呼吸医学