Living in lower income zip codes is associated with more severe chronic rhinosinusitis

Codispoti, Christopher D.; Tapke, David E.; LoSavio, Phillip; Batra, Pete S.; Mahdavinia, Mahboobeh

doi:10.1016/j.anai.2017.10.025

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…Other social factors, such as healthcare access, socioeconomic factors, and patient education, have also been described, although we did not study these characteristics because we previously found our patients to be quite homogeneous with respect to these characteristics . However, it is very likely that social factors may also have an impact on adherence with CRS medications …”

Section: Discussionmentioning

confidence: 96%

“…23 However, it is very likely that social factors may also have an impact on adherence with CRS medications. 10,24 This study should be interpreted in the context of its limitations. Adherence was only measured by asking patients to recall their own adherence rather any objective measure, introducing both recall bias and perhaps a desire on the patient's part to inflate adherence rates in an effort to not disappoint the physician.…”

Section: Discussionmentioning

confidence: 99%

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Intranasal corticosteroids and saline: Usage and adherence in chronic rhinosinusitis patients

et al. 2019

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Objective Intranasal saline irrigations and intranasal corticosteroids are supported by level‐1 evidence for medical management of chronic rhinosinusitis (CRS). We sought to study adherence with these medications. Methods Prospective study of 174 patients with CRS. Patients reported their usage of intranasal saline irrigation and intranasal corticosteroid over the preceding 3 months, at presentation, and a subsequent follow‐up visit 3 to 12 months later. Adherence was defined as reported medication usage for ≥6 days per week. Results At the time of presentation, 44.3% of patients were using an intranasal corticosteroid spray or irrigation ≥6 days/week, whereas only 24.1% were using saline irrigation ≥6 days per week. At follow‐up, 60.3% of patients were using either an intranasal corticosteroid spray or irrigation ≥6 days per week, whereas 35.6% were using saline irrigation ≥6 days per week. Adherence with intranasal corticosteroids was associated with comorbid asthma (adjusted odds ratio [OR] = 2.68, 95% confidence interval [CI]: 1.10–6.50, P = 0.029), allergy (OR = 2.22, 95% CI: 1.05–4.71, P = 0.037), and change in 22‐item Sinonasal Outcome Test score (OR = 0.98, 95% CI: 0.96–0.99, P = 0.027). Use of intranasal corticosteroid sprays versus irrigations (OR = 2.56, 95% CI: 0.84–7.83, P = 0.099) was suggestive of association with improved adherence. Adherence with intranasal saline irrigation was associated with age (OR = 1.02, 95% CI: 1.01–1.05, P = 0.034). Conclusion Usage and adherence with intranasal steroids and saline may be low in CRS patients even with management in a tertiary level, subspecialty rhinology clinic. Adherence with medications represents a major opportunity for improving patient care and outcomes, specifically by targeting patients with lower disease burden and improving convenience of medications. Level of Evidence 2C Laryngoscope, 130:852–856, 2020

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Intranasal corticosteroids and saline: Usage and adherence in chronic rhinosinusitis patients

et al. 2019

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“…The four therapeutic indications are sinusitis, obstructive chronic bronchitis, community-acquired respiratory diseases and cutaneous infections. Living in low-income geographical zones is associated with more serious chronic rhinosinusitis [26]. The prevalence of chronic bronchitis is linked to poverty, altitude, air pollution and policies on tobacco use [27].…”

Section: Discussionmentioning

confidence: 99%

The Characteristics of Care Provided to Population(s) in Precarious Situations in 2015. A Preliminary Study on the Universal Health Cover in France

Birault

Mignot

Caunes

et al. 2020

IJERPH

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Background: The French Universal Health Cover (CMU) aims to compensate for inequalities between precarious and non-precarious populations, enabling the former to access to free healthcare. These measures rely on the principle that precarious populations’ health improves if healthcare is free. We designed a study to examine whether CMU fails to compensate for inequalities in reimbursed drugs prescriptions in precarious populations. Material and method: This retrospective pharmaco-epidemiological study compared the Defined Daily Dose relative to different reimbursed drugs prescribed by general practitioners (GPs) to precarious and non-precarious patients in France in 2015. Data were analysed using Mann–Whitney tests. Findings: 6 out of 20 molecules were significantly under-reimbursed in precarious populations. 2 were over-reimbursed. The 12 remaining molecules did not differ between groups. Interpretation: The under-reimbursement of atorvastatin, rosuvastatin, tamsulosine and timolol reflects well-documented epidemiological differences between these populations. In contrast, the equal reimbursement of amoxicillin, pyostacine, ivermectin, salbutamol and tiopropium is likely an effect of lack of compensation for inequalities. Precarious patients are more affected by diseases that these molecules target (e.g., chronic bronchitis, bacterial pneumonia, cutaneous infections). This could also be the case for the equal and under-reimbursement of insulin glargine and metformin (targeting diabetes), respectively, although this has to be considered with caution. In conclusion, the French free healthcare cover does not fail to compensate for all but only for some selective inequalities in access to reimbursed drugs prescriptions. These results are discussed with respect to the interaction of the doctor–patient relationship and the holistic nature of primary care, potentially triggering burnout and empathy decrease and negatively impacting the quality of care in precarious populations.

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“…Younger children from low‐income households were at even higher risk of chronic school absenteeism. Lower income is associated with more severe CRS, possibly secondary to healthcare access barriers and insufficient subsequent disease control 8 . Moreover, we found two‐way interactions of CRS and asthma.…”

Section: Discussionmentioning

confidence: 64%

“…Lower income is associated with more severe CRS, possibly secondary to healthcare access barriers and insufficient subsequent disease control. 8 Moreover, we found two-way interactions of CRS and asthma. Previous research found childhood asthma is associated with school absence.…”

Section: Discussionmentioning

confidence: 65%

Children and young adults with chronic rhinosinusitis have higher rates of chronic school absenteeism

Cheng

Hassan

et al. 2021

Int Forum Allergy Rhinol

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Living in lower income zip codes is associated with more severe chronic rhinosinusitis

Cited by 6 publications

References 7 publications

Intranasal corticosteroids and saline: Usage and adherence in chronic rhinosinusitis patients

Intranasal corticosteroids and saline: Usage and adherence in chronic rhinosinusitis patients

The Characteristics of Care Provided to Population(s) in Precarious Situations in 2015. A Preliminary Study on the Universal Health Cover in France

Children and young adults with chronic rhinosinusitis have higher rates of chronic school absenteeism

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