Patients' and physicians' views on the management of acute maxillary sinusitis.

OBJECTIVES: To study the views of patients and physicians on the management of suspected acute maxillary sinusitis and on suggested changes in practice.
DESIGN: Cross-sectional survey and focus group interviews of both patients and physicians.
SETTING: Primary care in Finland.
RESULTS: A total of 175 patients and 245 physicians replied to the survey (response rates 88% and 70%, respectively). Eight focus groups were conducted, four with patients (n = 22) and four with physicians (n = 20). Patients had less trust than physicians in the natural healing process of acute maxillary sinusitis: only 33% as opposed to 95% of physicians agreed that acute maxillary sinusitis might heal without medication. The patients emphasised the importance of careful diagnosis. Physicians experienced the diagnostic uncertainty and the demands from authorities to use fewer antibiotics as problematic.
CONCLUSIONS: Most patients with suspected acute maxillary sinusitis primarily want the physician to aim at making a specific diagnosis. Physicians feel they are forced to prescribe too many antibiotics for sinusitis because of patient's expectations and lack of good diagnostic means for acute maxillary sinusitis. Better diagnostic tools, both national and local guidelines, and patient information might help to change practice towards the use of fewer antibiotics.