Primary care management of obstructive sleep apnoea (OSA) is as effective and more cost-effective than in-laboratory diagnosis, according to a study published online in the American Journal of Respiratory and Critical Care Medicine.
M. Ángeles Sánchez-Quiroga, M.D., from Virgen del Puerto Hospital in Madrid, and colleagues randomized 303 sequentially screened patients with an intermediate-to-high probability of OSA to primary care management (a portable monitor with automatic scoring and semi-automatic therapeutic decision-making) or in-laboratory management (polysomnography and specialized therapeutic decision-making). All patients received continuous positive airway pressure treatment or sleep hygiene and dietary treatment alone.
The researchers found that the primary care protocol was noninferior to the in-laboratory protocol based on use of the Epworth sleepiness scale. Furthermore, primary health care management was more cost-effective, with a lower cost of €537.8 per patient.
“Primary health care area management may be an alternative to in-laboratory management for patients with an intermediate to high OSA probability,” the authors wrote. “Given the clear economic advantage of outpatient management, this finding could change established clinical practice.”
REFERENCE: Sanchez-Quiroga et al: Primary Care Physicians Can Comprehensively Manage Sleep Apnoea Patients: A Non-inferiority Randomized Controlled Trial; https://www.atsjournals.org/doi/abs/10.1164/rccm.201710-2061OC?journalCode=ajrccm