Transition from APAP to CPAP may be a cost-effective health intervention in OSA patients
ABSTRACT Objective: Obstructive sleep apnea (OSA) is a common disorder associated with a significant economic burden. Continuous positive airway pressure (CPAP) and auto-titrating positive airway pressure (APAP) are recognized therapeutic options in patients with OSA, although treatment costs are h...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Pneumologia e Tisiologia
2021-12-01
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| Series: | Jornal Brasileiro de Pneumologia |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132021000600402&tlng=pt |
| _version_ | 1818974916719935488 |
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| author | Adelaide Alves Ana Rita Gigante Daniela Machado Inês Sanches Raquel Marçoa Inês Franco Regina Monteiro Carla Nogueira Daniela Ferreira |
| author_facet | Adelaide Alves Ana Rita Gigante Daniela Machado Inês Sanches Raquel Marçoa Inês Franco Regina Monteiro Carla Nogueira Daniela Ferreira |
| author_sort | Adelaide Alves |
| collection | DOAJ |
| description | ABSTRACT Objective: Obstructive sleep apnea (OSA) is a common disorder associated with a significant economic burden. Continuous positive airway pressure (CPAP) and auto-titrating positive airway pressure (APAP) are recognized therapeutic options in patients with OSA, although treatment costs are higher with APAP. We conducted a study aimed at evaluating the effectiveness and potential cost savings resulting from the implementation of a protocol guiding the transition to CPAP in OSA patients previously treated with APAP. Methods: This prospective study included patients with OSA under APAP who were followed up at the Sleep Medicine outpatient clinic of a tertiary referral hospital between January 2019 and January 2021. Treatment was switched to CPAP in patients who met the following criteria: satisfactory adaptation and adherence to APAP, residual apnea-hypopnea index (AHI) of < 5/hour, and no relevant air leaks. APAP and CPAP outcomes were compared and an estimate of the savings obtained by the transition from APAP to CPAP was calculated. Results: Ninety-three patients were included in the study. APAP and CPAP were both effective in correcting obstructive events and improving daytime sleepiness. No significant differences were found regarding treatment adherence and tolerance between both PAP modalities. The selection of fixed-pressure CPAP through 90th or 95th percentile APAP pressure proved to be effective and an alternative strategy to titration polysomnography. At the end of this two-year study, the transition from APAP to CPAP enabled savings of at least 10,353€. Conclusion: The transition from APAP to CPAP may be an effective, well-tolerated, safe, and cost-saving strategy in patients with OSA. |
| first_indexed | 2024-12-20T15:47:40Z |
| format | Article |
| id | doaj.art-cb9e9e31ffb44337aa58d51c5d08825f |
| institution | Directory Open Access Journal |
| issn | 1806-3756 |
| language | English |
| last_indexed | 2024-12-20T15:47:40Z |
| publishDate | 2021-12-01 |
| publisher | Sociedade Brasileira de Pneumologia e Tisiologia |
| record_format | Article |
| series | Jornal Brasileiro de Pneumologia |
| spelling | doaj.art-cb9e9e31ffb44337aa58d51c5d08825f2022-12-21T19:34:51ZengSociedade Brasileira de Pneumologia e TisiologiaJornal Brasileiro de Pneumologia1806-37562021-12-0147610.36416/1806-3756/e20210286Transition from APAP to CPAP may be a cost-effective health intervention in OSA patientsAdelaide Alveshttps://orcid.org/0000-0002-3299-9838Ana Rita GiganteDaniela Machadohttps://orcid.org/0000-0002-0472-8491Inês Sancheshttps://orcid.org/0000-0002-1664-1297Raquel Marçoahttps://orcid.org/0000-0002-6741-5230Inês FrancoRegina MonteiroCarla Nogueirahttps://orcid.org/0000-0002-5094-9113Daniela FerreiraABSTRACT Objective: Obstructive sleep apnea (OSA) is a common disorder associated with a significant economic burden. Continuous positive airway pressure (CPAP) and auto-titrating positive airway pressure (APAP) are recognized therapeutic options in patients with OSA, although treatment costs are higher with APAP. We conducted a study aimed at evaluating the effectiveness and potential cost savings resulting from the implementation of a protocol guiding the transition to CPAP in OSA patients previously treated with APAP. Methods: This prospective study included patients with OSA under APAP who were followed up at the Sleep Medicine outpatient clinic of a tertiary referral hospital between January 2019 and January 2021. Treatment was switched to CPAP in patients who met the following criteria: satisfactory adaptation and adherence to APAP, residual apnea-hypopnea index (AHI) of < 5/hour, and no relevant air leaks. APAP and CPAP outcomes were compared and an estimate of the savings obtained by the transition from APAP to CPAP was calculated. Results: Ninety-three patients were included in the study. APAP and CPAP were both effective in correcting obstructive events and improving daytime sleepiness. No significant differences were found regarding treatment adherence and tolerance between both PAP modalities. The selection of fixed-pressure CPAP through 90th or 95th percentile APAP pressure proved to be effective and an alternative strategy to titration polysomnography. At the end of this two-year study, the transition from APAP to CPAP enabled savings of at least 10,353€. Conclusion: The transition from APAP to CPAP may be an effective, well-tolerated, safe, and cost-saving strategy in patients with OSA.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132021000600402&tlng=ptObstructive sleep apnea (OSA)continuous positive airway pressure (CPAP)auto-titrating positive airway pressure (APAP)health care costs |
| spellingShingle | Adelaide Alves Ana Rita Gigante Daniela Machado Inês Sanches Raquel Marçoa Inês Franco Regina Monteiro Carla Nogueira Daniela Ferreira Transition from APAP to CPAP may be a cost-effective health intervention in OSA patients Jornal Brasileiro de Pneumologia Obstructive sleep apnea (OSA) continuous positive airway pressure (CPAP) auto-titrating positive airway pressure (APAP) health care costs |
| title | Transition from APAP to CPAP may be a cost-effective health intervention in OSA patients |
| title_full | Transition from APAP to CPAP may be a cost-effective health intervention in OSA patients |
| title_fullStr | Transition from APAP to CPAP may be a cost-effective health intervention in OSA patients |
| title_full_unstemmed | Transition from APAP to CPAP may be a cost-effective health intervention in OSA patients |
| title_short | Transition from APAP to CPAP may be a cost-effective health intervention in OSA patients |
| title_sort | transition from apap to cpap may be a cost effective health intervention in osa patients |
| topic | Obstructive sleep apnea (OSA) continuous positive airway pressure (CPAP) auto-titrating positive airway pressure (APAP) health care costs |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132021000600402&tlng=pt |
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