Patients’ with obstructive sleep apnoea syndrome (OSAS) preferences and demand for treatment: a discrete choice experiment

RATIONALE Despite its high level of effectiveness, initial acceptance of continuous positive airway pressure (CPAP) and regular use in patients with obstructive sleep apneoa syndrome (OSAS) are still an issue. Alternatively, oral appliances (OAs) can be recommended. To improve patient engagement in their treatment, physicians are advised to take into account patient preferences and to share the therapeutic decision. We aimed to determine patients' preferences for OSAS treatment-related attributes, and to predict patients' demand for both CPAP and OAs. METHODS A discrete choice experiment (DCE) was performed in 121 newly diagnosed patients consecutively recruited in a sleep unit. RESULTS Regression parameters were the highest for impact on daily life and effectiveness ahead of side effects. In the French context, the demanding probabilities for CPAP and OAs were 60.2% and 36.2%, respectively. They were sensitive to the variation in the amount of out-of-pocket expenses for both CPAP and OAs. CONCLUSIONS This first DCE in OSAS emphasises the importance to communicate with patients before the implementation of treatment.