Use of Telemonitoring for CPAP Therapy Control in OSA Patients: Impact on Cost and Process Improvements.

Introduction: In Spain, 2 million people are treated for obstructive sleep apnoea. Continuous positive airway pressure, the gold-standard therapy, requires regular follow-up and periodic evaluation of the efficacy of the treatment via a titration examination, i.e. autoCPAP test. Telemonitoring use is increasing and this study aims to evaluate the cost impact of its use for therapy evaluation instead of the standard ambulatory autoCPAP test. Methods: This prospective observational study includes 100 OSA patients under CPAP therapy who volunteered to test telemonitoring as an alternative therapy control tool. Costs for both the patients and the Sleep Unit were calculated and compared for the standard of care (ambulatory autoCPAP (SoC)), vs alternative telemonitoring option (TM). Results: More than half (54%) of the patients preferred the TM option vs only 47.5% of the SoC patients. Patients inclining towards telemonitoring option were mainly reported to be more than 10 years youngers, mainly active workers (63%), travelling more distance to the Sleep Unit (16 vs 8 km) and spending more expenses in travel than those who preferred SoC (median 30€). 29% of active workers left their jobs to attend the SoC. The costs related to the use of the Sleep Unit resources were found to be lower in the TM option compared to the SoC option (0.47 vs 3.09 euros per patient attended). Conclusions: The use of TM for follow-up CPAP therapy enables the patient to save travel costs and to reduce absenteeism but also to save assistential burden and therefore to reduce the Sleep Unit workload and optimize the care activity.