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Thompson EE. Early COVID-19 Home-Based Care Knowledge and Efficacies: Comparing Ghanaian and US Respondents. JOURNAL OF HEALTH COMMUNICATION 2023:1-9. [PMID: 37154031 DOI: 10.1080/10810730.2023.2208080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Home-based care messages were part of behavioral modification interventions to mitigate COVID-19 spread early in the pandemic. What remains unclear is the types of home-based care knowledge people have and whether different kinds of home-based care knowledge influence a person's self-efficacy and response efficacy in managing mild cases. Using a cross-sectional online survey, this exploratory study investigated differences in biomedical and alternative knowledge about COVID-19 home-based care and their association with self and response efficacy from respondents in Ghana and the US. With a total sample of 736 made up of 50.3% from Ghana and 49.7% from the US, the average age range was of 39-48 years. Sixty two percent were females and 38% males. Using chi-square goodness of fit tests, t-tests, and multiple regression for analysis, we found that US respondents had higher biomedical knowledge while Ghanaian respondents had higher alternative knowledge. Although self-efficacy and response efficacy were high in both countries, both kinds of knowledge did not independently improve respondents' self-efficacy or response efficacy. However, a combination of biomedical and alternative home-based care knowledge items predicted self and response efficacy. Health promoters need to consider ways of utilizing both knowledge types in a complimentary manner during disease outbreaks.
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Affiliation(s)
- Esi E Thompson
- The Media School, Indiana University, Bloomington, Indiana, USA
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2
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Frequency and causes of self-medication in patients with chronic rhinosinusitis, North of Iran, 2018-2019. Eur Arch Otorhinolaryngol 2022; 279:3973-3980. [PMID: 35083517 DOI: 10.1007/s00405-021-07224-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/13/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE Chronic rhinosinusitis (CRS) is a frequent respiratory disease. As self-medication is a common issue in the world, this study aimed to estimate its frequency in patients with CRS. METHODS 144 CRS patients referred to a university hospital, were evaluated for self-medication, included type, duration, frequency, and its causes, their SNOT-22 questionnaire and Lund-MacKay scores. The data were analyzed using SPSS v.21 and the level of significance was considered as P ≥ 0.05. RESULTS 30.6% of the cases used self-medication (65.9% used chemical drugs and 63.6% used herbal drugs), not associated with their age, gender, educational or economic level. The most common chemical drugs were antibiotics, analgesics and decongestants (75.9%, 55.2% and 10.3%, respectively) and the most common non-pharmaceutical agents included steam inhalation and herbal infusions (71.4%). The efficacy of self-medication was rated as "none" to "little" in 54.64% of cases. The mean SNOT-22 score was 59.54 ± 10.93 and 73.27 ± 8.12 in cases without and with self-medication (P = 0.034), and the mean Lund-MacKay score was 11.8 ± 5.3 and 17.2 ± 4.3 in cases without and with self-medication, respectively (P = 0.002). The top reasons for self-medication were "considering the disease unimportant" and believing chemical drugs being "harmful", "expensive", or "non-effective". Most patients who used self-medication did "not" advise it to others (80%). CONCLUSION The high rate of self-medication in CRS patients calls for greater attention to this issue in these patients. It seems that self-medication is significantly associated with more severe grades of disease and lower QOL in CRS cases.
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Rastogi S, Verma A. Jalaneti (saline nasal irrigation) as primary intervention in suspected rhino-orbito-cerebral mucormycosis helps improving the recovery: A case report. J Ayurveda Integr Med 2021; 13:100516. [PMID: 34736856 PMCID: PMC8560025 DOI: 10.1016/j.jaim.2021.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 11/01/2022] Open
Abstract
The ongoing COVID-19 pandemic has resulted in several opportunistic infections like mucormycosis (MCR) to surface. Although this is commonly afflicting immunocompromised people managed through prolonged ICU care, epidemiological observations suggest that it is also associated with conditions like uncontrolled diabetes. Due to its invasive nature and systemic reach, MCR has high mortality warranting an early diagnosis and treatment. We present here a case of a non-COVID, diabetic patient having acute onset paranasal and periorbital swelling with headache suspected for rhino-orbito-cerebral MCR. The case was innovatively dealt with jalaneti (saline nasal irrigation) seeing a delay in the institution of definitive anti-fungal therapy. Six sittings of jalaneti in four days had been able to give near complete symptomatic relief in paranasal swelling and headache even before the endoscopic nasal debridement and anti-fungal therapy was initiated. Seeing the urgency of diagnosis and treatment in any suspected case of MCR, a simple and self-administrable procedure like jalaneti seems to have a high value for its possible role in reducing the sinus inflammation and reducing the disease intensity in order to find more time for the proper diagnosis and treatment initiation. Negligible cost of jalaneti, its easy administration, and minimal adversity potential are additional advantages for proposing jalaneti as a possible prophylaxis in MCR. More serious clinical research is urgently required to confirm the observations made in this single case report and to extend its benefits to the people suffering with MCR.
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Affiliation(s)
- Sanjeev Rastogi
- PG Department of Kaya Chikitsa, State Ayurvedic College and Hospital, Lucknow, 226003, India.
| | - Ankita Verma
- PG Department of Kaya Chikitsa, State Ayurvedic College and Hospital, Lucknow, 226003, India.
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Shrestha K, Salati H, Fletcher D, Singh N, Inthavong K. Effects of head tilt on squeeze-bottle nasal irrigation - A computational fluid dynamics study. J Biomech 2021; 123:110490. [PMID: 34022532 DOI: 10.1016/j.jbiomech.2021.110490] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 11/28/2022]
Abstract
Nasal irrigation is a widely recognized treatment for several sinonasal diseases. However, there is a lack of clear evidence-based guidelines for optimal irrigation delivery to improve lavage and topical drug delivery. This study uses computational fluid dynamics (CFD) to assess the effects of different head tilt positions on sinonasal coverage, residence time and shear stresses in squeeze-bottle nasal irrigation. A sinonasal cavity computational model was constructed from a high-resolution CT scan of a healthy, 25-year-old Asian female. The Volume of Fluid method was used to track the interface between the two immiscible fluids (air and water). The direction of gravity was varied to simulate different head tilt-positions (0° Straight, 45° Forward, 45° Left, 45° Right and 45° Backward) during nasal irrigation with 150 mL liquid via a squeeze bottle through the left nostril for 2 s with a 0.1 s acceleration/deceleration time. The results showed that the 45° backward head tilt position was the most effective in delivering irrigation to the ethmoid, frontal and sphenoid sinuses. Altering head tilt had minimal impact on irrigation delivery to the maxillary sinuses. Maximum wall shear stresses seen in localized areas of the sinus mucosa varied significantly with different head tilt angles. However, the difference in mean wall shear stress on the sinus surfaces was marginal with changing head tilt position. The findings suggest that an optimized head tilt position can be identified to improve liquid irrigation to targeted sinuses, as per treatment requirements (lavage and topical drug delivery).
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Affiliation(s)
- Kendra Shrestha
- Mechanical & Automotive Engineering, RMIT University, Bundoora, Victoria 3083, Australia
| | - Hana Salati
- Mechanical & Automotive Engineering, RMIT University, Bundoora, Victoria 3083, Australia
| | - David Fletcher
- School of Chemical and Biomolecular Engineering, The University of Sydney, Australia
| | - Narinder Singh
- Dept of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Australia; School of Medicine, The University of Sydney, NSW 2006, Australia
| | - Kiao Inthavong
- Mechanical & Automotive Engineering, RMIT University, Bundoora, Victoria 3083, Australia.
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5
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Orlandi RR, Kingdom TT, Smith TL, Bleier B, DeConde A, Luong AU, Poetker DM, Soler Z, Welch KC, Wise SK, Adappa N, Alt JA, Anselmo-Lima WT, Bachert C, Baroody FM, Batra PS, Bernal-Sprekelsen M, Beswick D, Bhattacharyya N, Chandra RK, Chang EH, Chiu A, Chowdhury N, Citardi MJ, Cohen NA, Conley DB, DelGaudio J, Desrosiers M, Douglas R, Eloy JA, Fokkens WJ, Gray ST, Gudis DA, Hamilos DL, Han JK, Harvey R, Hellings P, Holbrook EH, Hopkins C, Hwang P, Javer AR, Jiang RS, Kennedy D, Kern R, Laidlaw T, Lal D, Lane A, Lee HM, Lee JT, Levy JM, Lin SY, Lund V, McMains KC, Metson R, Mullol J, Naclerio R, Oakley G, Otori N, Palmer JN, Parikh SR, Passali D, Patel Z, Peters A, Philpott C, Psaltis AJ, Ramakrishnan VR, Ramanathan M, Roh HJ, Rudmik L, Sacks R, Schlosser RJ, Sedaghat AR, Senior BA, Sindwani R, Smith K, Snidvongs K, Stewart M, Suh JD, Tan BK, Turner JH, van Drunen CM, Voegels R, Wang DY, Woodworth BA, Wormald PJ, Wright ED, Yan C, Zhang L, Zhou B. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol 2021; 11:213-739. [PMID: 33236525 DOI: 10.1002/alr.22741] [Citation(s) in RCA: 357] [Impact Index Per Article: 119.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Abstract
I. EXECUTIVE SUMMARY BACKGROUND: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR-RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR-RS-2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence-based findings of the document. METHODS ICAR-RS presents over 180 topics in the forms of evidence-based reviews with recommendations (EBRRs), evidence-based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. RESULTS ICAR-RS-2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence-based management algorithm is provided. CONCLUSION This ICAR-RS-2021 executive summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS.
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Affiliation(s)
| | | | | | | | | | - Amber U Luong
- University of Texas Medical School at Houston, Houston, TX
| | | | - Zachary Soler
- Medical University of South Carolina, Charleston, SC
| | - Kevin C Welch
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | | | | | | | - Claus Bachert
- Ghent University, Ghent, Belgium.,Karolinska Institute, Stockholm, Sweden.,Sun Yatsen University, Gangzhou, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - David A Gudis
- Columbia University Irving Medical Center, New York, NY
| | - Daniel L Hamilos
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Richard Harvey
- University of New South Wales and Macquarie University, Sydney, New South Wales, Australia
| | | | | | | | | | - Amin R Javer
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | | | | | | | - Valerie Lund
- Royal National Throat Nose and Ear Hospital, UCLH, London, UK
| | - Kevin C McMains
- Uniformed Services University of Health Sciences, San Antonio, TX
| | | | - Joaquim Mullol
- IDIBAPS Hospital Clinic, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | - Alkis J Psaltis
- University of Adelaide, Adelaide, South Australia, Australia
| | | | | | | | - Luke Rudmik
- University of Calgary, Calgary, Alberta, Canada
| | - Raymond Sacks
- University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | - De Yun Wang
- National University of Singapore, Singapore, Singapore
| | | | | | | | - Carol Yan
- University of California San Diego, La Jolla, CA
| | - Luo Zhang
- Capital Medical University, Beijing, China
| | - Bing Zhou
- Capital Medical University, Beijing, China
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Swathi PS, Raghavendra BR, Saoji AA. Health and therapeutic benefits of Shatkarma: A narrative review of scientific studies. J Ayurveda Integr Med 2021; 12:206-212. [PMID: 33454186 PMCID: PMC8039332 DOI: 10.1016/j.jaim.2020.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/20/2020] [Accepted: 11/24/2020] [Indexed: 12/17/2022] Open
Abstract
Shatkarma, also known as Shatkriya are a set of six yogic cleansing techniques described in the Hatha Yoga texts. Several health benefits of these procedures are indicated in the traditional texts of Yoga. However, there is no comprehensive literature about the scientific evidence on Shatkriya. Hence, we searched in PubMed, PubMed Central and Google Scholar databases to review relevant articles in English. The search yielded a total 723 references, published from 1976 to April 2020. Based on the inclusion and exclusion criteria, 37 articles were included in this review. We found scientific studies on four out of six cleansing techniques. The limited evidence on Shatkriya suggests positive effects on various physiological and clinical domains. The practice of dhauti was found to enhance respiratory functions and was useful in digestive disorders. Nasal cleansing, neti was particularly found beneficial in managing the rhinosinusitis in age groups ranging from children to adults. Although trataka practice was found to enhance cognition and bring a state of relaxation, but there was no evidence supporting its role in eye disorders. Kapalabhati practice appears to have a beneficial role in the activation of sympathetic nervous system, enhance cognition, and improve overall metabolism. Further large-scale clinical trials with robust designs are warranted to evaluate the effects of Shatkriya in health and disease.
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Affiliation(s)
- P S Swathi
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bengaluru, 560019, India.
| | - B R Raghavendra
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bengaluru, 560019, India
| | - Apar Avinash Saoji
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bengaluru, 560019, India
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Rabago D, Kille T, Mundt M, Obasi C. Results of a RCT assessing saline and xylitol nasal irrigation for CRS and fatigue in Gulf War illness. Laryngoscope Investig Otolaryngol 2020; 5:613-620. [PMID: 32864432 PMCID: PMC7444787 DOI: 10.1002/lio2.425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/09/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To assess the efficacy of saline nasal irrigation (S-NI) and xylitol nasal irrigation (X-NI) for chronic rhinosinusitis in participants with Gulf War illness (GWI). METHODS This 26 week, 3-arm (1:1:1) randomized controlled trial examined veterans meeting criteria for GWI with moderate-to-severe chronic rhinosinusitis and fatigue symptoms. All participants received standard of care for chronic rhinosinusitis (CRS); additionally, S-NI or X-NI participants added twice-daily NI using 2% saline or 5% xylitol solutions. Outcomes included disease-specific quality of life (primary; sino-nasal outcome test [SNOT-20]; 0-100 points), overall quality of life (Short-Form 36), and fatigue (Multidimensional Fatigue Index). Outcome assessors were blind to allocation group. Intention-to-treat analysis used repeated measures modeling; statistical significance was evaluated at the two-sided α level of .05. RESULTS Randomization (N = 40) produced three similar groups regarding sex (male, 80%), age (53.8 ± 7.8 years), duration (19.8 ± 7.7 years), and illness severity (48.5 ± 12.7 SNOT-20 points). Age- and gender-adjusted between-group comparison showed that X-NI participants, compared with control, reported improved SNOT-20 scores at 8 weeks (13.5 points, 95% confidence interval [CI] -27.9 to 0.9) and at 26 weeks (15.4 points, 95% CI -30.1 to -0.6). S-NI participants improved by 13.4 points (95% CI -28.8, 2.1) at 26 weeks compared with control.The improvement in both NI groups approached minimal clinical important difference compared to control for the SNOT-20 in the general population. Secondary outcomes were not different between groups. Satisfaction in both irrigation groups was high. CONCLUSIONS This randomized controlled trial suggests that NI with saline or xylitol improves chronic sinus symptoms among participants with GWI with improvement scores similar to those in the general population. LEVEL OF EVIDENCE 1b, individual randomized controlled trial.
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Affiliation(s)
- David Rabago
- Department of Family and Community MedicinePennsylvania State UniversityHersheyPennsylvaniaUSA
| | - Tony Kille
- Department of Surgery, Division of OtolaryngologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Marlon Mundt
- Department of Family MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Chidi Obasi
- Department of Family MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
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Stuart B, Becque T, Moore M, Little P. Clustering of continuous and binary outcomes at the general practice level in individually randomised studies in primary care - a review of 10 years of primary care trials. BMC Med Res Methodol 2020; 20:83. [PMID: 32293280 PMCID: PMC7158044 DOI: 10.1186/s12874-020-00971-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 04/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In randomised controlled trials, the assumption of independence of individual observations is fundamental to the design, analysis and interpretation of studies. However, in individually randomised trials in primary care, this assumption may be violated because patients are naturally clustered within primary care practices. Ignoring clustering may lead to a loss of power or, in some cases, type I error. METHODS Clustering can be quantified by intra-cluster correlation (ICC), a measure of the similarity between individuals within a cluster with respect to a particular outcome. We reviewed 17 trials undertaken by the Department of Primary Care at the University of Southampton over the last ten years. We calculated the ICC for the primary and secondary outcomes in each trial at the practice level and determined whether ignoring practice-level clustering still gave valid inferences. Where multiple studies collected the same outcome measure, the median ICC was calculated for that outcome. RESULTS The median intra-cluster correlation (ICC) for all outcomes was 0.016, with interquartile range 0.00-0.03. The median ICC for symptom severity was 0.02 (interquartile range (IQR) 0.01 to 0.07) and for reconsultation with new or worsening symptoms was 0.01 (IQR 0.00, 0.07). For HADS anxiety the ICC was 0.04 (IQR 0.02, 0.05) and for HADS depression was 0.02 (IQR 0.00, 0.05). The median ICC for EQ. 5D-3 L was 0.01 (IQR 0.01, 0.04). CONCLUSIONS There is evidence of clustering in individually randomised trials primary care. The non-zero ICC suggests that, depending on study design, clustering may not be ignorable. It is important that this is fully considered at the study design phase.
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Affiliation(s)
- Beth Stuart
- Primary Care and Population Sciences, Aldermoor Health Centre, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK.
| | - Taeko Becque
- Primary Care and Population Sciences, Aldermoor Health Centre, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Michael Moore
- Primary Care and Population Sciences, Aldermoor Health Centre, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Paul Little
- Primary Care and Population Sciences, Aldermoor Health Centre, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
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Affiliation(s)
- David King
- Primary Care Clinical Unit, The University of Queensland, Australia
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Vennik J, Eyles C, Thomas M, Hopkins C, Little P, Blackshaw H, Schilder A, Boardman J, Philpott CM. Management strategies for chronic rhinosinusitis: a qualitative study of GP and ENT specialist views of current practice in the UK. BMJ Open 2018; 8:e022643. [PMID: 30573482 PMCID: PMC6303610 DOI: 10.1136/bmjopen-2018-022643] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To explore general practitioner (GP) and ears, nose and throat (ENT) specialist perspectives of current treatment strategies for chronic rhinosinusitis (CRS) and care pathways through primary and secondary care. DESIGN Semi-structured qualitative telephone interviews as part of the MACRO programme (Defining best Management for Adults with Chronic Rhinosinusitis) SETTING: Primary care and secondary care ENT outpatient clinics in the UK. PARTICIPANTS Twelve GPs and 9 ENT specialists consented to in-depth telephone interviews. Transcribed recordings were managed using NVivo software and analysed using inductive thematic analysis. MAIN OUTCOME MEASURES Healthcare professional views of management options and care pathways for CRS. RESULTS GPs describe themselves as confident in recognising CRS, with the exception of assessing nasal polyps. In contrast, specialists report common missed diagnoses (eg, allergy; chronic headache) when patients are referred to ENT clinics, and attribute this to the limited ENT training of GPs. Steroid nasal sprays provide the foundation of treatment in primary care, although local prescribing restrictions can affect treatment choice and poor adherence is perceived to be the causes of inadequate symptom control. Symptom severity, poor response to medical treatment and patient pressure drive referral, although there is uncertainty about optimal timing. Treatment decisions in secondary care are based on disease severity, polyp status, prior medical treatment and patient choice, but there is major uncertainty about the place of longer courses of antibiotics and the use of oral steroids. Surgery is regarded as an important treatment option for patients with severe symptoms or with nasal polyps, although timing of surgery remains unclear, and the uncertainty about net long-term benefits of surgery makes balancing of benefits and risks more difficult. CONCLUSIONS Clinicians are uncertain about best management of patients with CRS in both primary and secondary care and practice is varied. An integrated care pathway for CRS is needed to improve patient management and timely referral.
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Affiliation(s)
- Jane Vennik
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Caroline Eyles
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Mike Thomas
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Paul Little
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | | | - Jim Boardman
- Fifth Sense: the charity of people with smell and taste disorders, Chinnor, Oxfordshire, UK
| | - Carl M Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
- James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
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11
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Optimisation of Medical Management of Chronic Rhinosinusitis. CURRENT OTORHINOLARYNGOLOGY REPORTS 2018. [DOI: 10.1007/s40136-018-0211-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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12
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Llor C. Reducing antimicrobial resistance through population empowerment. Eur J Gen Pract 2017; 23:51-52. [PMID: 28270019 PMCID: PMC5774270 DOI: 10.1080/13814788.2016.1276166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/20/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Carl Llor
- University Institute in Primary Care Research Jordi Gol, Primary Healthcare Centre Via RomaBarcelonaSpain
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Leydon GM, McDermott L, Thomas T, Halls A, Holdstock-Brown B, Petley S, Wiseman C, Little P. 'Well, it literally stops me from having a life when it's really bad': a nested qualitative interview study of patient views on the use of self-management treatments for the management of recurrent sinusitis (SNIFS trial). BMJ Open 2017; 7:e017130. [PMID: 29101134 PMCID: PMC5695339 DOI: 10.1136/bmjopen-2017-017130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To explore the experience and perceptions of illness, the decision to consult a general practitioner and the use of self-management approaches for chronic or recurrent sinusitis. DESIGN Qualitative semistructured interview study. SETTING UK primary care. PARTICIPANTS 32 participants who had been participating in the 'SNIFS' (Steam inhalation and Nasal Irrigation For recurrent Sinusitis) trial in the South of England. METHOD Thematic analysis of semistructured telephone interviews. RESULTS Participants often reported dramatic impact on both activities and their quality of life. Participants were aware of both antibiotic side effects and resistance, but if they had previously been prescribed antibiotics, many patients believed that they would be necessary for the future treatment of sinusitis. Participants used self-help treatments for short and limited periods of time only. In the context of the trial, steam inhalation used for recurrent sinusitis was described as acceptable but is seen as having limited effectiveness. Nasal irrigation was viewed as acceptable and beneficial by more patients. However, some participants reported that they would not use the treatment again due to the uncomfortable side effects they experienced, which outweighed any symptom relief, which may have resulted had they continued. CONCLUSIONS Steam inhalation is acceptable but seen as having limited effectiveness. Nasal irrigation is generally acceptable and beneficial for symptoms, but detailed information on the correct procedure and potential benefits of persisting may increase acceptability and adherence in those patients who find it uncomfortable. TRIAL REGISTRATION NUMBER ISRCTN 88204146.
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Affiliation(s)
- Geraldine M Leydon
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Lisa McDermott
- Primary Care and Public Health Sciences, King's College, 614, 6th Floor, Capital House, 42 Weston Street, London, SE1 3QD, UK
| | - Tammy Thomas
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Amy Halls
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Ben Holdstock-Brown
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Stephen Petley
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Clare Wiseman
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Paul Little
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
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