Clinical management and use of health care resources in the treatment of nasal polyposis in Spanish allergy centers: The POLAR study
| Autor: | Rondón, C., Dávila, I., Navarro Pulido, A. M., Sánchez, M. C., Montoro, J., Matheu, V., Lluch-Bernal, M., Fernández-Parra, B., Ibáñez, M. D., TERESA DORDAL, Colás, C., Antón, E., Valero, A. |
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| Přispěvatelé: | Rhinoconjunctivitis Committee, Spanish Society of Allergy and Clinical Immunology., [Rondón,C] Allergy Unit, Regional University Hospital of Malaga, IBIMA, UMA, Malaga, Spain. [Dávila,I] Allergy Service, University Hospital of Salamanca, Instituto de Investigaciones Biosanitarias de Salamanca, IBSAL, Salamanca, Spain. [Navarro Pulido, AM] Allergy UGC-IC, Hospital El Tomillar, Dos Hermanas, Sevilla, Spain. [Sánchez,MC] Allergy Unit, CE Virgen de la Cinta, Hospital Juan Ramón Jimenez, Huelva, Spain. [Montoro,J] Allergy Unit, Hospital Universitario Arnau de Vilanova, Facultad de Medicina, Universidad Católica de Valencia 'San Vicente Mártir', Valencia, Spain. [Matheu,V] Allergy Service, Hospital del Tórax (Ofra), Complejo Hospitalario Universitario NSC and Unidad de Investigación, Hospital Universitario NS Candelaria, Tenerife, Spain. [Lluch-Bernal,M] Allergy Service, Hospital Virgen del Valle, Toledo, Spain. [Fernández-Parra,B] Allergy Service, Hospital El Bierzo, Ponferrada, León, Spain. [Ibañez,MD] Allergy Service, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. [Dordal,MT] Allergy Service, Hospital Municipal de Badalona, Badalona, Spain and Allergy Service, Sant Pere Claver Fundació Sanitària, Barcelona, Spain. [Colás,C] Allergy Service, Hospital Clínico-Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain. [Antón,E] Allergy Service, University Hospital Marqués de Valdecilla, Santander, Spain. [Valero,A] Allergy Unit, Servei de Pneumologia i Al•lèrgia Respiratòria, Hospital Clínic, Barcelona, Spain and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Centro de Investigación Biomédica en red en Enfermedades Respiratorias (CIBERES), Spain., The study was funded by Merck Sharp & Dohme. |
| Předmět: |
Atopy
Diagnóstico Check Tags::Male [Medical Subject Headings] Named Groups::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings] Atopia Pólipos nasales Treatment Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional Studies [Medical Subject Headings] Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] Evaluación alergológica Health care resources Check Tags::Female [Medical Subject Headings] Diseases::Respiratory Tract Diseases::Nose Diseases::Nasal Polyps [Medical Subject Headings] Health Care::Health Care Quality Access and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [Medical Subject Headings] Health Care::Health Care Quality Access and Evaluation::Delivery of Health Care::Health Resources [Medical Subject Headings] Named Groups::Persons::Age Groups::Adolescent [Medical Subject Headings] Diagnosis Nasal polyps Named Groups::Persons::Age Groups::Adult [Medical Subject Headings] Allergological evaluation Tratamiento Recursos sanitarios |
| Zdroj: | Scopus-Elsevier |
| Popis: | Journal Article; Multicenter Study; Observational Study; Research Support, Non-U.S. Gov't; BACKGROUND Nasal polyposis (NP) is a chronic inflammatory disease that constitutes a major health problem with significant comorbidities and a considerable associated socioeconomic burden. OBJECTIVE To describe the clinical features and management of patients with NP attending Spanish allergy centers, the use of health care resources, and the degree of compliance with the diagnostic and therapeutic recommendations of the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS). METHODS We performed a multicenter, observational, and cross-sectional epidemiologic study of 671 patients consulting for NP in 67 Spanish allergy departments. We used sociodemographic and clinical questionnaires to evaluate clinical characteristics, use of health care resources, diagnostic methods, and treatment administered. RESULTS NP was closely associated with asthma (66%), allergic rhinitis (45.9%), and hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (26%). Atopy was present in the 50% of cases, with Dermatophagoides pteronyssinus as the most frequent sensitizing allergen. Eleven percent of NP patients visited the emergency department during the previous year, and more than 58% used primary care, allergy, or otorhinolaryngology services. The most frequently used diagnostic tests were skin prick tests (93.6%) and anterior rhinoscopy (79.4%). Intranasal corticosteroids were the drug class most frequently prescribed by allergists (74.6%). Specific immunotherapy was prescribed in 21% of patients. CONCLUSIONS NP is a chronic inflammatory disease that generates considerable use of health care resources. The close association with atopy, asthma, and NSAID hypersensitivity highlights the usefulness of an allergy workup in all patients with NP. Analysis of the clinical management of NP by allergists in Spain revealed a high degree of compliance with EPOS diagnostic and therapeutic recommendations. Yes Introducción: La poliposis nasal es una enfermedad inflamatoria crónica asociada frecuentemente a otras enfermedades. Constituye un importante problema sanitario con un gasto económico considerable. Objetivo: Describir las características y manejo clínico de los pólipos nasales (NP) de pacientes asistidos en los centros alergológicos españoles, incluido el consumo de recursos sanitarios, y el grado de cumplimiento de los esquemas diagnósticos y terapéuticos del documento europeo de consenso sobre rinosinusitis y pólipos nasales (EPOS). Métodos: Estudio epidemiológico multicéntrico, observacional y transversal. Se estudiaron 671 pacientes con NP atendidos en 67 servicios de Alergología de España. Las características clínicas, el consumo de recursos sanitarios, los métodos diagnósticos y el tratamiento se evaluaron mediante cuestionarios sociodemográficos y clínicos. Resultados: Se detectó una alta asociación entre NP y asma (66%), rinitis alérgica (45,9%) e hipersensibilidad a antiinflamatorios no esteroideos (AINES) (26%). Se detectó atopia en el 50% de los casos, siendo el D. pteronyssinus el alérgeno más frecuente. El 11% requirió asistencia en urgencias el año anterior, y más del 58% asistencia en atención primaria, alergología u otorrinolaringología. Las pruebas diagnósticas más utilizadas fueron las pruebas cutáneas (93,6%) y rinoscopia anterior (79,4%). Los corticoides intranasales (74,6%) representaron el principal tratamiento farmacológico recomendado. La inmunoterapia específica se prescribió en el 21% de los pacientes. Conclusiones: Los NP es una enfermedad inflamatoria crónica con un elevado consumo de recursos sanitarios. La alta asociación con atopia, asma e hipersensibilidad a AINES resalta la utilidad de la evaluación alergólogica en estos pacientes. El manejo clínico de los NP por alergólogos españoles mostró un alto grado de cumplimiento con los esquemas diagnósticos y terapéuticos EPOS. |
| Databáze: | OpenAIRE |
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