Trial Outcomes & Findings for Cost Effectiveness of Ambulatory Management for Veterans With Sleep Apnea (NCT NCT00880165)

NCT ID: NCT00880165

Last Updated: 2014-04-21

Results Overview

VA sleep-study and treatment medical service use will be derived from the case report form; and costed out using VA acquisition costs. Other medical service use will be derived from VA administrative records. Non-VA medical service use will be derived from patient interview and will be costed out using federal reimbursement schedules. Costs will be stratified by whether or not they are related to the diagnosis and treatment of OSA.Cost and preferences are assessed for each entire arm.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

296 participants

Primary outcome timeframe

Medical service use and cost will be collected every 3 months for the entire observation period. Thus the shortest duration of follow-up in the study is anticipated to be 3 months, while the longest will be 2.25 years.

Results posted on

2014-04-21

Participant Flow

Participant milestones

Participant milestones
Measure
In-laboratory Testing
In-laboratory testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be prescribed continuous positive airway pressure treatment.
Home Unattended Testing
Home unattended testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be prescribed continuous positive airway pressure treatment.
Overall Study
STARTED
148
148
Overall Study
COMPLETED
86
98
Overall Study
NOT COMPLETED
62
50

Reasons for withdrawal

Reasons for withdrawal
Measure
In-laboratory Testing
In-laboratory testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be prescribed continuous positive airway pressure treatment.
Home Unattended Testing
Home unattended testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be prescribed continuous positive airway pressure treatment.
Overall Study
Withdrawal by Subject
27
23
Overall Study
Not diagnosed with OSA
14
8
Overall Study
Required BIPAP or oxygen treatment
12
4
Overall Study
Lost to follow
9
15

Baseline Characteristics

Cost Effectiveness of Ambulatory Management for Veterans With Sleep Apnea

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm 1
n=148 Participants
In-laboratory testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be started on treatment with continuous positive airway pressure.
Arm 2
n=148 Participants
Home unattended testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be started on treatment with continuous positive airway pressure.
Total
n=296 Participants
Total of all reporting groups
Age, Continuous
51.8 years
STANDARD_DEVIATION 10.4 • n=5 Participants
55.1 years
STANDARD_DEVIATION 10.3 • n=7 Participants
53.2 years
STANDARD_DEVIATION 10.4 • n=5 Participants
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
137 Participants
n=5 Participants
135 Participants
n=7 Participants
272 Participants
n=5 Participants
Age, Categorical
>=65 years
11 Participants
n=5 Participants
13 Participants
n=7 Participants
24 Participants
n=5 Participants
Sex: Female, Male
Female
10 Participants
n=5 Participants
13 Participants
n=7 Participants
23 Participants
n=5 Participants
Sex: Female, Male
Male
138 Participants
n=5 Participants
135 Participants
n=7 Participants
273 Participants
n=5 Participants
Region of Enrollment
United States
148 participants
n=5 Participants
148 participants
n=7 Participants
296 participants
n=5 Participants
Functional Outcome of Sleep Questionnaire
14.7 units on a scale
STANDARD_DEVIATION 2.9 • n=5 Participants
15.0 units on a scale
STANDARD_DEVIATION 3.2 • n=7 Participants
14.9 units on a scale
STANDARD_DEVIATION 3.0 • n=5 Participants

PRIMARY outcome

Timeframe: Medical service use and cost will be collected every 3 months for the entire observation period. Thus the shortest duration of follow-up in the study is anticipated to be 3 months, while the longest will be 2.25 years.

Population: Participants diagnosed with obstructive sleep apnea who were prescribed continuous positive airway pressure (CPAP) treatment. Of the 148 individuals randomized to each arm, 110 in the in-lab testing arm and 113 in the home testing arm were prescribed CPAP. Results from these 223 subjects were used in the per protocol analysis.

VA sleep-study and treatment medical service use will be derived from the case report form; and costed out using VA acquisition costs. Other medical service use will be derived from VA administrative records. Non-VA medical service use will be derived from patient interview and will be costed out using federal reimbursement schedules. Costs will be stratified by whether or not they are related to the diagnosis and treatment of OSA.Cost and preferences are assessed for each entire arm.

Outcome measures

Outcome measures
Measure
Arm 1
n=110 Participants
In-laboratory testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be started on treatment with continuous positive airway pressure.
Arm 2
n=113 Participants
Home unattended testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be started on treatment with continuous positive airway pressure.
Cost
4621 dollars
2
4057 dollars

SECONDARY outcome

Timeframe: 3 months

Population: Participants diagnosed with obstructive sleep apnea who were prescribed continuous positive airway pressure (CPAP) treatment. Of the 148 individuals randomized to each arm, 110 in the in-lab testing arm and 113 in the home testing arm were prescribed CPAP. Results from these 223 subjects were used in the per protocol analysis.

Change score from baseline of self-administered validate questionnaire of functional outcome following 3 months of positive airway pressure treatment

Outcome measures

Outcome measures
Measure
Arm 1
n=110 Participants
In-laboratory testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be started on treatment with continuous positive airway pressure.
Arm 2
n=113 Participants
Home unattended testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be started on treatment with continuous positive airway pressure.
Functional Outcome of Sleep Questionnaire
1.85 units on a scale
Standard Deviation 2.46
1.74 units on a scale
Standard Deviation 2.81

SECONDARY outcome

Timeframe: 3 months

Population: Participants diagnosed with obstructive sleep apnea who were prescribed continuous positive airway pressure (CPAP) treatment. Of the 148 individuals randomized to each arm, 110 in the in-lab testing arm and 113 in the home testing arm were prescribed CPAP. Results from these 223 subjects were used in the per protocol analysis.

Mean daily hours of use of continuous positive airway pressure over the 3 month intervention

Outcome measures

Outcome measures
Measure
Arm 1
n=110 Participants
In-laboratory testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be started on treatment with continuous positive airway pressure.
Arm 2
n=113 Participants
Home unattended testing Continuous positive airway pressure apparatus: Veterans randomized to both arms who are diagnosed with obstructive sleep apnea will be started on treatment with continuous positive airway pressure.
Continuous Positive Airway Pressure Adherence
2.92 hours per day
Standard Deviation 2.32
3.49 hours per day
Standard Deviation 2.45

Adverse Events

Arm 1

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Arm 2

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Samuel T. Kuna, MD

Philadelphia VA Medical Center

Phone: 215-823-4400

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place