PT  - JOURNAL ARTICLE
AU  - Patrick B. Murphy
AU  - Maxime Patout
AU  - Clare Flach
AU  - Gill Arbane
AU  - Antoine Cuvelier
AU  - Abdel Douiri
AU  - Mark Elliott
AU  - George Kaltsakas
AU  - Swapna Mandal
AU  - Jean-Louis Pepin
AU  - Michael I. Polkey
AU  - Nicholas Hart
TI  - Late Breaking Abstract - Cost-effectiveness of outpatient (OP) vs. inpatient (IP) setup of home non-invasive ventilation (NIV) in obesity hypoventilation syndrome (OHS): A Randomised Clinical Trial
AID  - 10.1183/13993003.congress-2019.RCT5099
DP  - 2019 Sep 28
TA  - European Respiratory Journal
PG  - RCT5099
VI  - 54
IP  - suppl 63
4099  - http://erj.ersjournals.com/content/54/suppl_63/RCT5099.short
4100  - http://erj.ersjournals.com/content/54/suppl_63/RCT5099.full
SO  - Eur Respir J2019 Sep 28; 54
AB  - Introduction: Guidelines recommend that OHS patients are electively admitted to hospital for initiation of home NIV, but it is unknown whether OP setup is safe and as effective as IP setup. We hypothesised that OP NIV setup would be more cost-effective than IP NIV setup.Method: OHS patients were recruited to a multicentre international clinical trial. Patients were randomised to IP setup, using nurse-led overnight titration with standard fixed level NIV, or OP setup using an auto-titrating NIV device (AVAPS-AE, Philips, US). Primary outcome was cost-effectiveness difference at 3 months with carbon dioxide (PaCO2) embedded as an a priori non-inferiority clinical effectiveness safety outcome. Costs were converted to UK £ sterling 2017.Results: 82 patients were randomised (41 IP vs. 41 OP; 53 UK, 29 France). Baseline data were matched with age 59±14yrs, body mass index (BMI) 47±10kg/m2, PaCO2 6.8±0.6kPa and severe respiratory insufficiency questionnaire (SRI) 52±19. There was no difference at 3 months between OP vs. IP setup in additional quality adjusted life months (QALM), total cost, SRI or PaCO2 (non-inferior).[Table 1]Conclusion: OP NIV setup in OHS, using an auto-titrating device, has similar cost as IP setup using nurse-led overnight titration NIV. There was no difference in clinical effectiveness or safety between IP and OP setup.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, RCT5099.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).