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Follow-Up Adherence Is Associated with Outcomes After Endoscopic Sinus Surgery.

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Title: Follow-Up Adherence Is Associated with Outcomes After Endoscopic Sinus Surgery.
Authors: Shen, Sarek A., Jafari, Aria, Qualliotine, Jesse R., DeConde, Adam S.
Source: Annals of Otology, Rhinology & Laryngology. Jul2020, Vol. 129 Issue 7, p707-714. 8p.
Subjects: Diagnosis of ear diseases, Paranasal sinus surgery, Ambulatory surgery, Chronic diseases, Conferences & conventions, Endoscopy, Face, Longitudinal method, Medical appointments, Medical records, Patient compliance, Postoperative period, Quality of life, Sinusitis, Treatment effectiveness, Retrospective studies, Severity of illness index, Acquisition of data methodology
Geographic Terms: Illinois
Abstract: Background: Clinical follow-up after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) allows for assessment of the sinonasal cavity, debridement, and tailoring of medical therapies. Frequency and timing of postoperative clinical visits is debated, but the impact of adherence on disease-specific outcomes is not well understood. In this longitudinal study, we assessed the association between follow-up adherence and quality of life (QOL) outcomes in the 12 months after ESS. Methods: A retrospective review of patients undergoing ambulatory ESS for CRS between 11/2016 and 1/2018 was performed. We assessed sociodemographic characteristics, radiographic severity, and QOL utilizing the 22-item sinonasal outcome test (SNOT-22). Patients were categorized as "non-adherent," "moderately-adherent," and "fully-adherent" to a 1-, 3- and 5-week postoperative visit schedule. Results: A total of 166 patients met the inclusion criteria. Of these, 55 (33.1%) were fully-adherent, 105 (63.2%) were moderately-adherent, and 6 (3.6%) were non-adherent within the 6 weeks following ESS. In the immediate postoperative period, fully-adherent patients demonstrated worse QOL (SNOT-22: 31.2 ± 23.1 vs 27.5 ± 17.6, P =.047). This cohort also had greater psychological dysfunction at baseline and 12-months (P <.05) after ESS. Extra-nasal symptom scores increased at a lower rate in the fully-adherent cohort (0.12 vs 1.29 points per 6 months, P =.038), as did ear/facial symptoms (1.17 vs 3.05 points per 6 months, P =.044). Conclusion: Despite worse symptom severity in the immediate postoperative period, patients who are more adherent to the follow-up schedule demonstrated slower return of symptoms in the extra-rhinological and ear-facial domains. These findings suggest that clinical adherence and management may impact the long-term evolution of ESS outcomes. [ABSTRACT FROM AUTHOR]
Copyright of Annals of Otology, Rhinology & Laryngology is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Follow-Up Adherence Is Associated with Outcomes After Endoscopic Sinus Surgery.
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  Data: Background: Clinical follow-up after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) allows for assessment of the sinonasal cavity, debridement, and tailoring of medical therapies. Frequency and timing of postoperative clinical visits is debated, but the impact of adherence on disease-specific outcomes is not well understood. In this longitudinal study, we assessed the association between follow-up adherence and quality of life (QOL) outcomes in the 12 months after ESS. Methods: A retrospective review of patients undergoing ambulatory ESS for CRS between 11/2016 and 1/2018 was performed. We assessed sociodemographic characteristics, radiographic severity, and QOL utilizing the 22-item sinonasal outcome test (SNOT-22). Patients were categorized as &quot;non-adherent,&quot; &quot;moderately-adherent,&quot; and &quot;fully-adherent&quot; to a 1-, 3- and 5-week postoperative visit schedule. Results: A total of 166 patients met the inclusion criteria. Of these, 55 (33.1%) were fully-adherent, 105 (63.2%) were moderately-adherent, and 6 (3.6%) were non-adherent within the 6 weeks following ESS. In the immediate postoperative period, fully-adherent patients demonstrated worse QOL (SNOT-22: 31.2 &#177; 23.1 vs 27.5 &#177; 17.6, P =.047). This cohort also had greater psychological dysfunction at baseline and 12-months (P &lt;.05) after ESS. Extra-nasal symptom scores increased at a lower rate in the fully-adherent cohort (0.12 vs 1.29 points per 6 months, P =.038), as did ear/facial symptoms (1.17 vs 3.05 points per 6 months, P =.044). Conclusion: Despite worse symptom severity in the immediate postoperative period, patients who are more adherent to the follow-up schedule demonstrated slower return of symptoms in the extra-rhinological and ear-facial domains. These findings suggest that clinical adherence and management may impact the long-term evolution of ESS outcomes. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Annals of Otology, Rhinology &amp; Laryngology is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=143636706
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      – Type: doi
        Value: 10.1177/0003489420908291
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      – Code: eng
        Text: English
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        PageCount: 8
        StartPage: 707
    Subjects:
      – SubjectFull: Diagnosis of ear diseases
        Type: general
      – SubjectFull: Paranasal sinus surgery
        Type: general
      – SubjectFull: Ambulatory surgery
        Type: general
      – SubjectFull: Chronic diseases
        Type: general
      – SubjectFull: Conferences & conventions
        Type: general
      – SubjectFull: Endoscopy
        Type: general
      – SubjectFull: Face
        Type: general
      – SubjectFull: Longitudinal method
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      – SubjectFull: Medical appointments
        Type: general
      – SubjectFull: Medical records
        Type: general
      – SubjectFull: Patient compliance
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      – SubjectFull: Postoperative period
        Type: general
      – SubjectFull: Quality of life
        Type: general
      – SubjectFull: Sinusitis
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Severity of illness index
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      – SubjectFull: Acquisition of data methodology
        Type: general
      – SubjectFull: Illinois
        Type: general
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      – TitleFull: Follow-Up Adherence Is Associated with Outcomes After Endoscopic Sinus Surgery.
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              Text: Jul2020
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              Y: 2020
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