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Chronic rhinosinusitis: a qualitative study of patient views and experiences of current management in primary and secondary care

Chronic rhinosinusitis: a qualitative study of patient views and experiences of current management in primary and secondary care
Chronic rhinosinusitis: a qualitative study of patient views and experiences of current management in primary and secondary care
Objectives:
To explore patient views and perspectives of current management of chronic rhinosinusitis (CRS) in 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
Twenty-five patients consented to in-depth telephone interviews. Transcribed recordings were managed using NVivo software and analysed using inductive thematic analysis

Results
CRS has a significant impact on patients’ quality of life, affecting their ability to work effectively, their social interactions and daily living. Patients seek help when symptoms become unmanageable, but can become frustrated with the primary care system with difficulties obtaining an appointment, and lack of continuity of care. Patients perceive that GPs can be dismissive of CRS symptoms, and patients often prioritise other concerns when they consult. Health system barriers and poor communication can result in delays in accessing appropriate treatment and referral. Adherence to intranasal steroids is a problem and patients are uncertain about correct technique. Nasal irrigation can be time-consuming and difficult for patients to use. Secondary care consultations can appear rushed, and patients would like specialists to take a more ‘holistic’ approach to their management. Surgery is often considered a temporary solution, appropriate when medical options have been explored.

Conclusions
Patients are frustrated with the management of their CRS, and poor communication can result in delays in receiving appropriate treatment and timely referral. Patients seek better understanding of their condition and guidance to support treatments decisions in light of uncertainties around the different medical and surgical options. Better coordinated care between general practice and specialist settings and consistency of advice has the potential to increase patient satisfaction and improve outcomes.
2044-6055
Vennik, Jane
6ee78166-5a7a-433b-87fc-018771f20b19
Eyles, Caroline
f8518cbb-669f-4cf6-bacb-4a174e385483
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Hopkins, Claire
8ed0a5e3-92a3-4988-9c2b-b0e51a8a044c
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Blackshaw, Helen
89f97306-9bba-42b3-a09f-4574d08bd711
Schilder, Anne G.M.
4efe172e-cbc9-4d1b-b089-f293f5c626ef
Savage, Imogen
bbd4e709-4e1e-4d27-b040-94a12ff49c33
Philpot, Carl
22c69c5e-03fe-443c-b4f2-1a6be07a03ba
Vennik, Jane
6ee78166-5a7a-433b-87fc-018771f20b19
Eyles, Caroline
f8518cbb-669f-4cf6-bacb-4a174e385483
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Hopkins, Claire
8ed0a5e3-92a3-4988-9c2b-b0e51a8a044c
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Blackshaw, Helen
89f97306-9bba-42b3-a09f-4574d08bd711
Schilder, Anne G.M.
4efe172e-cbc9-4d1b-b089-f293f5c626ef
Savage, Imogen
bbd4e709-4e1e-4d27-b040-94a12ff49c33
Philpot, Carl
22c69c5e-03fe-443c-b4f2-1a6be07a03ba

Vennik, Jane, Eyles, Caroline, Thomas, Mike, Hopkins, Claire, Little, Paul, Blackshaw, Helen, Schilder, Anne G.M., Savage, Imogen and Philpot, Carl (2019) Chronic rhinosinusitis: a qualitative study of patient views and experiences of current management in primary and secondary care. BMJ Open, 9, [e022644]. (doi:10.1136/bmjopen-2018-022644).

Record type: Article

Abstract

Objectives:
To explore patient views and perspectives of current management of chronic rhinosinusitis (CRS) in 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
Twenty-five patients consented to in-depth telephone interviews. Transcribed recordings were managed using NVivo software and analysed using inductive thematic analysis

Results
CRS has a significant impact on patients’ quality of life, affecting their ability to work effectively, their social interactions and daily living. Patients seek help when symptoms become unmanageable, but can become frustrated with the primary care system with difficulties obtaining an appointment, and lack of continuity of care. Patients perceive that GPs can be dismissive of CRS symptoms, and patients often prioritise other concerns when they consult. Health system barriers and poor communication can result in delays in accessing appropriate treatment and referral. Adherence to intranasal steroids is a problem and patients are uncertain about correct technique. Nasal irrigation can be time-consuming and difficult for patients to use. Secondary care consultations can appear rushed, and patients would like specialists to take a more ‘holistic’ approach to their management. Surgery is often considered a temporary solution, appropriate when medical options have been explored.

Conclusions
Patients are frustrated with the management of their CRS, and poor communication can result in delays in receiving appropriate treatment and timely referral. Patients seek better understanding of their condition and guidance to support treatments decisions in light of uncertainties around the different medical and surgical options. Better coordinated care between general practice and specialist settings and consistency of advice has the potential to increase patient satisfaction and improve outcomes.

Text
MACRO Patient views REVISION 2 11-Jan-19 CLEAN - Accepted Manuscript
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More information

Accepted/In Press date: 24 January 2019
e-pub ahead of print date: 23 April 2019

Identifiers

Local EPrints ID: 427884
URI: http://eprints.soton.ac.uk/id/eprint/427884
ISSN: 2044-6055
PURE UUID: ff490dfc-c2df-4fab-8f7c-dc9853de388f
ORCID for Jane Vennik: ORCID iD orcid.org/0000-0003-4602-9805
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873

Catalogue record

Date deposited: 01 Feb 2019 17:30
Last modified: 12 Jul 2024 04:01

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Contributors

Author: Jane Vennik ORCID iD
Author: Caroline Eyles
Author: Mike Thomas
Author: Claire Hopkins
Author: Paul Little ORCID iD
Author: Helen Blackshaw
Author: Anne G.M. Schilder
Author: Imogen Savage
Author: Carl Philpot

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