Open AccessHealth Preference Measures in Patients with Obstructive Sleep Apnea Syndrome Undergoing Continuous Positive Airway Pressure Therapy: Data from a Randomized Trial
Author(s) -
Fabian Huber,
Michaël Furian,
Malcolm Kohler,
Tsogyal D. Latshang,
Yvonne Nussbaumer-Ochsner,
Alexander Turk,
Otto D. Schoch,
I Laube,
Robert Thurnheer,
Konrad E. Bloch
Publication year - 2021
Publication title -
respiration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.264
H-Index - 81
eISSN - 1423-0356
pISSN - 0025-7931
DOI - 10.1159/000513306
Subject(s) - medicine , epworth sleepiness scale , continuous positive airway pressure , obstructive sleep apnea , confidence interval , randomized controlled trial , apnea–hypopnea index , physical therapy , sleep apnea , positive airway pressure , health utilities index , polysomnography , apnea , anesthesia , health related quality of life , disease
Background: In patients with obstructive sleep apnea syndrome (OSAS), the preference-based, health-related quality of life in terms of utility has not been extensively studied. Objective: To address this point, we compared the performance of different instruments assessing utility in patients with OSAS undergoing continuous positive airway pressure (CPAP) therapy. Materials and Methods: Data of 208 patients with OSAS (28 women, mean ± SE age 54.4 ± 0.7 years, apnea-hypopnea index (AHI) 51.9 ± 1.8/h, Epworth sleepiness score 13.4 ± 0.2) participating in a randomized trial of different CPAP modalities over 2 years were analyzed. Evaluations included sleep studies, Epworth sleepiness scale, and several utility instruments that measure subjective health preference on a scale ranging from 1 (most preferred and perfect health) to 0 (least preferred and very poor health). Results: After 2 years of CPAP therapy, the mean ± SE AHI was 6.7 ± 1.5/h and Epworth score 7.9 ± 0.4, both p < 0.001 versus baseline. Baseline utilities and changes (95% confidence interval) after 2 years of CPAP therapy were EuroQol 5-dimensions 0.79 ± 0.01, 0.02 (0.00–0.05, p = 0.064); short-form 6-dimension medical outcome questionnaire 0.72 ± 0.01, 0.06 (0.04–0.08, p < 0.001); Euro-thermometer visual analog scale 0.70 ± 0.01, 0.09 (0.07–0.12, p < 0.001); time trade-off 0.82 ± 0.01, 0.03 (0.01–0.06, p = 0.002); and standard gamble 0.82 ± 0.01, −0.01 (−0.03 to 0.02, p = 0.712). Conclusion: The short-form 6-dimensions questionnaire, the Euro-thermometer, and the time trade-off instruments reflected the major clinical improvements in OSAS, while the EuroQoL 5-dimensions and standard gamble tests were not sensitive to CPAP effects. These results indicate that the evaluation of utility of a treatment for OSAS depends critically on the instrument used, which is important from an individual and societal perspective.