High costs and burden of illness in acute rhinosinusitis: real-life treatment patterns and outcomes in Swedish primary care

Abstract

Background: Few studies have investigated the impact of acute rhinosinusitis on disease-specific quality of life, and disease costs have not been studied previously in Scandinavia.

Aims: To study symptoms, treatment patterns, quality of life and costs in adults with acute rhinosinusitis.

Methods: This was an observational study in primary care. Patients aged 18-80 years seeking care for acute rhinosinusitis were evaluated using the Major Symptom Score (MSS) on days 0 and 15. Recommended and used treatments, quality of life and costs were assessed by questionnaires including EQ-5D™ and a visual analogue scale (VAS) on the same days.

Results: 150 patients were enrolled; 143 provided follow-up data. The proportion of MSS responders was 91%. Mean MSS decreased from 8.4 on day 0 (N = 150) to 1.9 on day 15 (N = 143). Patients reporting pain/discomfort and problems with usual activities decreased from 88.4% to 31.5% and from 43.2% to 1.4%, respectively, and mean VAS increased from 58.7 to 79.5. Intranasal corticosteroids were the most recommended and/or prescribed drugs. Total cost for an episode was 10,260 SEK (€1,102), of which 75% were indirect costs.

Conclusions: With treatment dominated by intranasal corticosteroids, a high proportion of responders and good symptom relief were seen. Acute rhinosinusitis seems to cause a high burden on quality of life and also a high cost for society.

Conflict of interest statement

BS and P Odebäck have received honoraria for educational activities from MSD, GSK and AstraZeneca. PS has received grants for studies and honoraria for educational activities from MSD, GSK, AstraZeneca and Novartis. P Olsson was employed by MSD during the conduct of the study and is currently employed by Boehringer-Ingelheim. JL is an employee of MSD and owns stock options and shares in Merck & Co. BS is an Associate Editor of the PCRJ, but was not involved in the editorial review of, nor the decision to publish, this article.

Figures

Figure 1. Study design

Figure 2. Recommended and/or prescribed medication for acute rhinosinusitis on day 0

Figure 3. Self-reported health status (EQ-5D™) of patients with acute rhinosinusitis on days 0 and 15