{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:53:19Z","timestamp":1793371999263,"version":"4.5.0"},"reference-count":34,"publisher":"BMJ","issue":"12","funder":[{"name":"Spanish Respiratory Society"},{"name":"Associacio Lleidatana de Respiratori"},{"name":"Fondo de Investigaci\u00f3n Sanitaria; Fondo Europeo de Desarrollo Regional (FEDER), Una manera de hacer Europa"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effectiveness and cost-effectiveness of primary care (PC) and sleep unit (SU) models for the management of subjects with suspected obstructive sleep apnoea (OSA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multicentre, open-label, two-arm, parallel-group, non-inferiority randomised controlled trial. A total of 302 subjects with suspected OSA and\/or resistant hypertension were consecutively enrolled, 149 were treated at 11 PC units and 153 patients at a SU. The primary outcomes were a 6-month change in the Epworth Sleepiness Scale (ESS) score and Health Utilities Index (HUI). The non-inferiority margin for the ESS score was \u22122.0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 80.2% and 70.6% of the PC and SU patients were diagnosed with OSA, respectively, and 59.3% and 60.4% of those were treated with CPAP in PC and SU units, respectively. The Apnoea\u2013Hypopnoea Index was similar between the groups (PC vs SU (median (IQR); 23.1 (26.8) events\/h vs 21.8 (35.2) events\/h), and the baseline ESS score was higher in the PC than in the SU group (10.3 (6.6) vs 9 (7.2)). After 6 months, the ESS score of the PC group decreased from a mean of 10.1 to 7.6 (\u22122.49; 95%\u2009CI \u22123.3 to \u22121.69), and that of the SU group decreased from 8.85 to 5.73 (\u22123.11; 95%\u2009CI \u22123.94 to 2.28). The adjusted difference between groups for the mean change in the ESS score was \u22121.25 (one-sided 95% CI \u22121.88; p=0.025), supporting the non-inferiority of PC management. We did not observe differences in the HUI between groups. The cost analysis showed a median savings of \u20ac558.14\/patient for the PC setting compared with the SU setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among patients with suspected OSA, the PC model did not result in a worse ESS score or HUI than the specialist model and generated savings in terms of management cost. Therefore, the PC model was more cost-efficient than the SU model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>Results; &gt;&gt;<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT02234765\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial results\">NCT02234765<\/jats:ext-link>, Clinical Trials.gov.<\/jats:p><\/jats:sec>","DOI":"10.1136\/thoraxjnl-2017-211237","type":"journal-article","created":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T09:15:31Z","timestamp":1533028531000},"page":"1152-1160","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":53,"title":["Management of obstructive sleep apnoea in a primary care vs sleep unit setting: a randomised controlled 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