RT Journal Article SR Electronic T1 Clinical outcomes and cost-effectiveness of using positive airways pressure to manage sleep apnoea in patients with type 2 diabetes in the UK JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP P281 VO 42 IS Suppl 57 A1 Julian Guest A1 Monica Panca A1 Erikas Sladkevicius YR 2013 UL http://erj.ersjournals.com/content/42/Suppl_57/P281.abstract AB Background and aims: To assess clinical outcomes and cost-effectiveness of positive airways pressure (PAP) in managing sleep apnoea patients with type 2 diabetes from the perspective of the UK’s National Health Service (NHS).Materials and methods: A case-control analysis was conducted using the case records of 150 PAP-treated patients and 150 matched non-PAP treated patients from the THIN database (a nationally representative database of patients registered with general practitioners in the UK). Regression models were used to assess the impact of patients' baseline variables on resource use and clinical outcomes. The analysis also estimated the cost-effectiveness of PAP compared to no PAP treatment over five years.Results: Patients’ mean age was 53.7 years, 82% were male and >80% of patients in both groups were obese at 5 years. The time between diagnosis of sleep apnoea and starting PAP treatment was a mean 19.6±31.2 months. Compliance with PAP fell to 89% in year 5. PAP-treated patients had significantly lower HbA1c levels at five years (66.0 versus 118.6 mmol/mol (8.2 versus 13.0%); p<0.03), indicative of better controlled diabetes. PAP treatment significantly increased patients’ health status by 0.28 quality-adjusted life years (QALYs) over five years and also increased the five-yearly NHS cost of management by £4,443 per patient. The cost per QALY gained with PAP was <£20,000. PAP remained cost-effective for plausible changes in the model’s inputs.Conclusion: Initiating treatment with PAP in sleep apnoea patients with type 2 diabetes leads to significantly better controlled diabetes and affords a cost-effective use of NHS resources.