Authors' objectives:

This report is a systematic literature review of the efficacy and safety of oxygen therapy for OSA treatment by age group (adults and children). It also contains a narrative review of the programs and clinical practice guidelines for oxygen therapy and OSA treatment elsewhere in Canada and around the world. The objective was to assess the appropriateness of offering OSA patients the care and services included in the home oxygen therapy program (POD). The organizational, social, ethical and economic aspects of OSA patient management in Quebec were also examined.

Authors' recommendations: Current data show that oxygen therapy is not an effective treatment for OSA, neither in adults nor in children. According to expert opinion, this therapy could be recommended in some cases as a last-resort treatment if other therapies have failed or during the waiting period for other therapies, or else as a treatment supplementary to other options. However, the literature shows that effective OSA treatments already exist, such as CPAP in adults and tonsillectomy and/or adenoidectomy in children.Given that no evidence demonstrates the efficacy of oxygen therapy, it was not considered relevant to assess either patient eligibility criteria or its budget impact on the home oxygen therapy program (POD). Nevertheless, a detailed analysis of this dimension could be performed at the request of the MSSS if an OSA management structure (program) were to be considered or if OSA patients were to be given access to available CPAP machines in the home oxygen therapy program (POD).Upon concluding this analysis, AETMIS found that:Obstructive sleep apnea is a recognized disorder and a growing public health problem.This disorder has major impacts on patients’ health and quality of life.The public health and social service system offers no mechanism for the management of OSA patients.The purpose and current structure of the home oxygen therapy program (POD) do not respond to the needs of OSA patients.A proven and recommended primary treatment for OSA in adults is available: continuous positive airway pressure (CPAP), which is not accessible to patients in the public system.On the basis of these data, AETMIS concludes that oxygen therapy is not an effective treatment for OSA, neither in adults nor in children. Furthermore, AETMIS is of the opinion that the MSSS should initiate a reflection on the public health system’s organizational and financial arrangements for OSA patient management. Special attention should be paid to adults’ access to CPAP treatment.

Project Status: Completed

URL for project: http://www.aetmis.gouv.qc.ca/site/phpwcms_filestorage/56b0d1ac32aaaf0022336834ae697b0f.pdf

Year Published: 2010

URL for published report: http://www.aetmis.gouv.qc.ca/site/en_publications_2010.phtml

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Agence d'évaluation des technologies et des modes d'intervention en santé

Contact Address: 2021, avenue Union, Bureau 10.083,Montreal, Quebec H3A S29, Canada.Tel: +1 514 873 2563; Fax: +1 514 873 1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: Agence d'Evaluation des Technologies et des Modes d'Intervention en Sante (AETMIS)