Disability perceived by primary care patients with posterior canal benign paroxysmal positional vertigo

Ricard Carrillo Muñoz, José Luis Ballve Moreno, Iván Villar Balboa, Yolanda Rando Matos, Oriol Cunillera Puertolas, Jesús Almeda Ortega, Estrella Rodero Perez, Xavier Monteverde Curto, Carles Rubio Ripollès, Noemí Moreno Farres, Austria Matos Mendez, Jean Carlos Gomez Nova, Marta Bardina Santos, Johan Josué Villarreal Miñano, Diana Lizzeth Pacheco Erazo, Anabella María Hernández Sánchez, Grupo de estudio del vértigo en atención primaria Florida, José Luis Ballve Moreno, Yolanda Rando Matos, Estrella Rodero Pérez, Xavier Monteverde Curto, Carles Rubio Ripollès, Noemí Moreno Farres, Jean Carlos Gómez Nova, Johan Josué Villarreal Miñano, Diana Lizzeth Pacheco Erazo, Raquel Adroer Martori, Anna Aguilar Margalejo, Olga Lucia Arias Agudelo, Silvia Cañadas Crespo, Laura Illamola Martín, Marta Sarró Maluquer, Lluís Solsona Díaz, Rosa Sorando Alastruey, Ricard Carrillo Muñoz, Iván Villar Balboa, Austria Matos Méndez, Marta Bardina Santos, Oriol Cunillera Puertolas, Jesús Almeda Ortega, Ricard Carrillo Muñoz, José Luis Ballve Moreno, Iván Villar Balboa, Yolanda Rando Matos, Oriol Cunillera Puertolas, Jesús Almeda Ortega, Estrella Rodero Perez, Xavier Monteverde Curto, Carles Rubio Ripollès, Noemí Moreno Farres, Austria Matos Mendez, Jean Carlos Gomez Nova, Marta Bardina Santos, Johan Josué Villarreal Miñano, Diana Lizzeth Pacheco Erazo, Anabella María Hernández Sánchez, Grupo de estudio del vértigo en atención primaria Florida, José Luis Ballve Moreno, Yolanda Rando Matos, Estrella Rodero Pérez, Xavier Monteverde Curto, Carles Rubio Ripollès, Noemí Moreno Farres, Jean Carlos Gómez Nova, Johan Josué Villarreal Miñano, Diana Lizzeth Pacheco Erazo, Raquel Adroer Martori, Anna Aguilar Margalejo, Olga Lucia Arias Agudelo, Silvia Cañadas Crespo, Laura Illamola Martín, Marta Sarró Maluquer, Lluís Solsona Díaz, Rosa Sorando Alastruey, Ricard Carrillo Muñoz, Iván Villar Balboa, Austria Matos Méndez, Marta Bardina Santos, Oriol Cunillera Puertolas, Jesús Almeda Ortega

Abstract

Background: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Little is known on how posterior canal BPPV affects health-related quality of life in patients diagnosed and treated at primary care facilities or on whether patients with subjective and objective disease perceive the effects differently. This study was designed to describe how patients diagnosed with posterior canal BPPV in primary care perceive disability.

Methods: Cross-sectional descriptive study performed at two urban primary care centers. Participants were patients aged 18 years or older with suspected posterior canal BPPV recruited for baseline evaluation in a clinical trial on the effectiveness of the Epley maneuver in primary care. The recruitment period was from November 2012 to January 2015. Perceived disability was evaluated using the Dizziness Handicap Inventory - Screening version (DHI-S). Other variables collected were age and sex, a history or diagnosis of anxiety or depression, treatment with antidepressants and/or anxiolytics, and results of the Dix-Hallpike (DH) test, which was considered positive when it triggered vertigo with or without nystagmus and negative when it triggered neither.

Results: The DH test was positive in 134 patients, 40.30% of whom had objective BPPV (vertigo with nystagmus). The median age of the patients was 52 years (interquartile range [IQR], 39.00-68.50 years) and 76.1% were women. The median total score on the DHI-S was 16 out of 40 (IQR, 8.00-22.00). Scores were higher (greater perceived disability) in women (p < 0.001) and patients with subjective BPPV (vertigo without nystagmus) (p = 0.033). The items perceived as causing the greatest disability were feeling depressed (67.1%) and worsening of the condition on turning over in bed (88%).

Conclusions: Patients diagnosed with posterior canal BPPV in primary care perceive their condition as a disability according to DHI-S scores, with higher levels of disability reported by women and patients with subjective BPPV. Feelings of depression and turning over in bed were associated with the greatest perceived difficulties.

Trial registration: ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://ichgcp.net/clinical-trials-registry/NCT01969513.

Keywords: Benign paroxysmal positional vertigo; Primary care; Quality of life.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study. DH = Dix-Hallpike

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