Chronic Rhinosinusitis Treatment Trends Contradict Guidelines

Many patients with chronic rhinosinusitis (CR) are not regularly treated with topical intranasal steroids (INS), despite guideline recommendations, according to a recent study.

INS has been shown to be highly effective at improving the symptoms and quality of life in patients with CR. In order to utilization patters for INS for CR, researchers conducted a retrospective review of a Canadian population-based health care administrative database involving 19057 adults with CR.
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Overall, the rate of INS utilization was 20.1 per 100 patients with CR (3821 of 19,057). The mean quantity of utilization of INS in the 3821 patients was 2.4 U (1 U = 1 bottle per month) per patient.

“This demonstrates that approximately 80% of patients with a recent diagnosis of [CR] failed to use a single unit of topical INS spray during management of their [CR] during the past 12 months,” they wrote.

“Topical intranasal steroid therapy continues to be underutilized for patients with [CR]. Given the negative impact of low-quality medical care, outcomes from this study indicate a need to further evaluate factors leading to the underutilization of a recommended treatment in patients with [CR] to improve overall health system performance,” the researchers concluded.

—Michael Potts

Reference:
Rudmik L, Xu Y, Liu M, et al. Utilization patterns of topical intranasal steroid therapy for chronic rhinosinusitis [published online August 25, 2016]. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2016.1110.