Virtual consultations for patients with obstructive sleep apnoea: a systematic review and meta-analysis. (14th December 2022)

• Record Type: Journal Article
• Authors: Alsaif, Sulaiman S.; Kelly, Julia L.; Little, Stuart; Pinnock, Hilary; Morrell, Mary J.; Polkey, Michael I.; Murphie, Phyllis
• Is Part Of: European respiratory review. Volume 31:Number 166(2022)
• Publication Date: 2022-12-14
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases; Respiratory organs -- Diseases; Respiratory organs -- Diseases -- Treatment; Electronic journals; Periodical; Periodicals; Periodicals; 616.2
• DOI: 10.1183/16000617.0180-2022
• Languages: English
• ISSNs: 0905-9180

Abstract

Background: The coronavirus disease 2019 pandemic has accelerated the adoption of virtual care strategies for the management of patients with obstructive sleep apnoea/hypopnoea syndrome (OSAHS). Research question: What is the effectiveness of virtual consultations compared to in-person consultations for the management of continuous positive airway pressure (CPAP) therapy in adult patients with OSAHS? Methods: A systematic review and meta-analysis (PROSPERO; CRD42022297532) based on six electronic databases plus manually selected journals was conducted in January 2022. Two researchers independently selected, quality appraised and extracted data. The co-primary outcomes were patient-reported sleepiness, assessed by the Epworth Sleepiness Scale (ESS), and reported cost-effectiveness. Results: 12 studies (n=1823 adults) were included in the review. Seven studies (n=1089) were included in the meta-analysis which showed no difference in the magnitude of improvement in patient-reported sleepiness scores between virtual and in-person consultations (mean difference −0.39, 95% CI −1.38–0.60; p=0.4), although ESS scores improved in both groups. Virtual care strategies modestly increased CPAP therapy adherence and were found to be less costly than in-person care strategies in the three Spanish trials that reported cost-effectiveness. Conclusion: The findings of this review suggest that virtual care delivered by telephone or video consultations is as effective as in-person consultations for improving subjective sleepiness in patients with OSAHS treated with CPAP. This clinical management strategy may also improve CPAP adherence without increasing the costs, supporting its potential as a follow-up management strategy, where patients prefer this approach. Virtual consultations are as effective as in-person consultations for follow-up management of adult patients with obstructive sleep apnoea treated with continuous positive airway pressure. Moreover, this healthcare strategy appears to be cost-effective. https://bit.ly/3UuyU3M