Rodney J Schlosser1, Kristina A Storck1, Luke Rudmik2, Timothy L Smith3, Jess C Mace3, Jose Mattos1, Zachary M Soler1. 1. Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC. 2. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada. 3. Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR.
Abstract
BACKGROUND: Chronic rhinosinusitis (CRS) has significant impacts upon productivity, economic metrics, and medication usage; however, factors that are associated with these economic outcomes are unknown. METHODS: We evaluated olfactory dysfunction in 221 patients with CRS using the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS) and the 40-item Smell Identification Test (SIT) and assessed whether an association existed between these olfactory metrics and healthcare utilization, productivity, and medication usage over the preceding 90 days. RESULTS: After adjusting for CRS-associated comorbidities, objective measures of disease, demographics, and CRS-specific quality of life (QOL), patients with lower QOD-NS scores (worse patient-reported olfaction) had more missed days of normal productivity and employment, worse productivity levels, more hours of missed employment due to physician visits, more time caring for sinuses, greater distance traveled to medical appointment, more days of oral steroid use, and higher odds of being on disability insurance. Clinical olfaction, as measured by SIT, was associated with greater distance traveled to medical appointment and higher odds of being on disability insurance, but did not correlate with other productivity measures. CONCLUSION: Impaired olfactory-specific QOL is associated with significantly worse economic and productivity metrics and increased medication usage even after adjusting for CRS-specific comorbidities, objective measures of disease, demographics, and severity of CRS-specific QOL. Future studies are warranted to determine if targeting the impaired olfactory-specific QOL noted in patients with CRS results in improved productivity and economic outcomes.
BACKGROUND:Chronic rhinosinusitis (CRS) has significant impacts upon productivity, economic metrics, and medication usage; however, factors that are associated with these economic outcomes are unknown. METHODS: We evaluated olfactory dysfunction in 221 patients with CRS using the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS) and the 40-item Smell Identification Test (SIT) and assessed whether an association existed between these olfactory metrics and healthcare utilization, productivity, and medication usage over the preceding 90 days. RESULTS: After adjusting for CRS-associated comorbidities, objective measures of disease, demographics, and CRS-specific quality of life (QOL), patients with lower QOD-NS scores (worse patient-reported olfaction) had more missed days of normal productivity and employment, worse productivity levels, more hours of missed employment due to physician visits, more time caring for sinuses, greater distance traveled to medical appointment, more days of oral steroid use, and higher odds of being on disability insurance. Clinical olfaction, as measured by SIT, was associated with greater distance traveled to medical appointment and higher odds of being on disability insurance, but did not correlate with other productivity measures. CONCLUSION: Impaired olfactory-specific QOL is associated with significantly worse economic and productivity metrics and increased medication usage even after adjusting for CRS-specific comorbidities, objective measures of disease, demographics, and severity of CRS-specific QOL. Future studies are warranted to determine if targeting the impaired olfactory-specific QOL noted in patients with CRS results in improved productivity and economic outcomes.
Authors: Neil Bhattacharyya; Richard R Orlandi; Jeff Grebner; Melissa Martinson Journal: Otolaryngol Head Neck Surg Date: 2011-02-03 Impact factor: 3.497
Authors: Luke Rudmik; Timothy L Smith; Rodney J Schlosser; Peter H Hwang; Jess C Mace; Zachary M Soler Journal: Laryngoscope Date: 2014-03-11 Impact factor: 3.325
Authors: Adam S DeConde; Jess C Mace; Jeremiah A Alt; Rodney J Schlosser; Timothy L Smith; Zachary M Soler Journal: Int Forum Allergy Rhinol Date: 2014-07-12 Impact factor: 3.858
Authors: Rodney J Schlosser; J Madison Hyer; Timothy L Smith; Jess C Mace; Bernadette M Cortese; Thomas W Uhde; Luke Rudmik; Zachary M Soler Journal: JAMA Otolaryngol Head Neck Surg Date: 2016-04 Impact factor: 6.223
Authors: Wytske J Fokkens; Valerie J Lund; Joachim Mullol; Claus Bachert; Isam Alobid; Fuad Baroody; Noam Cohen; Anders Cervin; Richard Douglas; Philippe Gevaert; Christos Georgalas; Herman Goossens; Richard Harvey; Peter Hellings; Claire Hopkins; Nick Jones; Guy Joos; Livije Kalogjera; Bob Kern; Marek Kowalski; David Price; Herbert Riechelmann; Rodney Schlosser; Brent Senior; Mike Thomas; Elina Toskala; Richard Voegels; De Yun Wang; Peter John Wormald Journal: Rhinol Suppl Date: 2012-03
Authors: Richard M Rosenfeld; David Andes; Neil Bhattacharyya; Dickson Cheung; Steven Eisenberg; Theodore G Ganiats; Andrea Gelzer; Daniel Hamilos; Richard C Haydon; Patricia A Hudgins; Stacie Jones; Helene J Krouse; Lawrence H Lee; Martin C Mahoney; Bradley F Marple; Col John P Mitchell; Robert Nathan; Richard N Shiffman; Timothy L Smith; David L Witsell Journal: Otolaryngol Head Neck Surg Date: 2007-09 Impact factor: 3.497
Authors: Jayant M Pinto; Kristen E Wroblewski; David W Kern; L Philip Schumm; Martha K McClintock Journal: PLoS One Date: 2014-10-01 Impact factor: 3.240
Authors: Jordan R Kuiper; Annemarie G Hirsch; Karen Bandeen-Roche; Agnes S Sundaresan; Bruce K Tan; Robert C Kern; Robert P Schleimer; Brian S Schwartz Journal: J Occup Environ Med Date: 2019-08 Impact factor: 2.162