Patient Satisfaction and Efficiency Benefits of a Novel Multidisciplinary Rhinology and Allergy Clinic

Abstract

Background: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the sinonasal mucosa and with strong associations to other immune-mediated comorbidities. Patients often require referral to both an otolaryngologist and an allergist/immunologist. This study is the first in the literature to describe a multidisciplinary clinic that offers patient care by subspecialists in rhinology and in allergy/immunology. Methods: One hundred twenty-nine patients were seen in the Comprehensive Sinus and Allergy Clinic (CSAC) between January 2016 and June 2017 and 43 selected patients were seen in both the standalone allergy and rhinology clinics over the same time period. Patient satisfaction was retrospectively assessed using a modified Press-Ganey satisfaction survey. Time to evaluation and time to follow up appointment were compared between the CSAC and both the standalone rhinology and allergy/immunology clinics. Results: Patients seen in the CSAC reported high satisfaction with the amount of time spent with the physicians (98.3%), quality of medical care (9.3 ± 1.0), and most importantly, the convenience of seeing two physicians in one day (9.5 ± 1.2). Time from referral placement to clinic evaluation ( P ≤ .02) and time to follow up appointment ( P ≤ .002) was significantly shorter for the CSAC than for the standalone Rhinology or Allergy clinics. Conclusion: Patients reported high satisfaction with the medical care provided and were also seen much faster in our multidisciplinary clinic as compared to standalone rhinology or allergy/immunology clinics. Overall, a multidisciplinary approach may be beneficial to patients presenting to tertiary referral centers with CRS and atopic conditions.

Biologics for severe uncontrolled chronic rhinosinusitis with nasal polyps: a change management approach. Consensus of the Joint Committee of Italian Society of Otorhinolaryngology on biologics in rhinology

“…The collaboration with an allergologist, pneumologist, immunologist and rheumatologist is crucial to define endotype of the disease and coexisting Type 2 comorbidities such as atopic dermatitis, eosinophilic esophagitis or gastroenteritis, N-ERD, allergic fungal rhinosinusitis, Churg Struss Syndrome etc. 76 , 77 .…”

Telemedicine, Patient Satisfaction, and Chronic Rhinosinusitis Care in the Era of COVID-19

“…For example, the impact of long-term outcomes, 22 surgical interventions, 23 patient education, 24,25 and multidisciplinary clinics on patient satisfaction has been evaluated. 26 Uniquely, the present study focused on patient satisfaction, and the quality of the physician-patient interaction, ensuring that it was not compromised in the virtual setting compared to traditional in-person clinic visits.…”

Practical recommendations for managing severe chronic rhinosinusitis with nasal polyps in the era of biologics

“…We suggest that rhinology centres where patients with uncontrolled, severe CRSwNP are followed should establish direct collaborative networks with pulmonologists to facilitate pathways and to jointly discuss candidates for biologics. Structured multidisciplinary boards may be helpful in clinical practice to discuss and quickly share information about candidates for biologics 23,[43][44][45] . Interestingly, our data demonstrate that ENTs concentrate more on correct asthma diagnosis, level of control, and previous and ongoing treatments (including systemic corticosteroids) than on comorbidities.…”