Home Respiratory Therapies in Patients With Obstructive Sleep Apnea: A Value-based Care Model in Spain

This document proposes a value-based care model to improve adherence and health outcomes in patients with obstructive sleep apnea (OSA) treated with CPAP. The current care model for OSA management adopts a uniform, volume-based approach for all patients, limiting personalized care and reducing service quality without providing objective outcome data. The value-based care model proposed here focuses on guiding all interventions towards improving treatment adherence, aiming to enhance health outcomes by increasing patients' quality of life and comfort with treatment. Key strategies to be implemented include education and support programs at the beginning of treatment, enhancing comfort in mask use, telemonitoring of adherence, patient involvement in the treatment progress, patient stratification based on adherence, and identifying individuals who may benefit from alternative treatments. A results-based funding model is also recommended to optimize resource allocation. Expected outcomes from these measures include a reduction in home visits and in-person consultations for stable patients, fewer non-adherent patients, more optimally treated patients, and overall improvements in treatment quality and effectiveness. Key indicators to evaluate the success of this approach include quality of life (measured through quality-of-life questionnaires), adherence levels (via telemonitoring), and CPAP comfort. Collectively, these strategies allow for a comprehensive approach, optimizing resources and ensuring personalized care that improves the experience and outcomes of OSA patients.