Lugo, 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.2021-03-192021-03-192019-10-241932-6203https://hdl.handle.net/2445/175412Introduction: 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.15 p.application/pdfengcc-by (c) Lugo, Vera M. et al., 2019http://creativecommons.org/licenses/by/3.0/esSíndromes d'apnea del sonQualitat de vidaTelecomunicació en medicinaSleep apnea syndromesQuality of lifeTelecommunication in medicineinfo:eu-repo/semantics/article6949362021-03-19info:eu-repo/semantics/openAccess31647838