Treating Obstructive Sleep Apnea in Primary Care Saves Costs

The quality of treatment for obstructive sleep apnea (OSA) provided by primary care physicians is not inferior to treatment provided by a sleep specialist, and significantly less expensive, according to an Australian study.

Ching Le Chai-Coetzer, MBBS, PhD, of the Adelaide Institute for Sleep Health in Adelaide, Australia and colleagues conducted a randomized, controlled, noninferiority study of 155 patients with OSA treated between September 2008 and June 2010, (81 treated by primary care and 74 treated by specialists). 

The physicians and nurses who participated in the primary care arm of the trial received 6 hours of education on the diagnosis and management of OSA. 

Those under primary care followed up with a nurse at 1, 3 and 6 months with physician appointments at 3 and 6 months.  Those treated by specialists were referred to ongoing treatment.

Both groups showed significant, similar improvements to daytime sleepiness scores after 6 months of follow-up, but significantly different costs of treatment. Costs for those treated under primary care were estimated as $1,819.44 per patient, while those treated by specialists paid an average of $3,067.86. 

"With adequate training of primary care physicians and practice nurses ... primary care management has the potential to improve patient access to sleep services," researchers concluded.

–Michael Potts

References

Chai-Coetzer C, Antic N, Rowland S, et al.  Primary Care vs Specialist Sleep Center Management of Obstructive Sleep Apnea and Daytime Sleepiness and Quality of Life [published online ahead of print March 13, 2013]  JAMA. 2013;309(10):997. doi:10.1001/jama.2013.1823.