Physicians’ Understanding of Severity of Nasal Polyp Symptoms

Mature Woman In Consultation With Female Doctor Sitting On Examination Couch In Office

Nasal polyps can be debilitating depending on the severity, but it remains unclear how well physicians recognize the frequency and severity of symptoms in patients with nasal polyps. This was the topic of a study published as part of the AAAAI Annual Meeting.

Patients with moderate-to-severe nasal polyps who had a consultation with a specialist physician between 2018 and 2019 (n=351) were surveyed per the Adelphi NPs Disease Specific Programme and completed the Sino-nasal Outcome Test (SNOT-22). A post-hoc analysis was performed to compare patients’ SNOT-22 responses with physicians’ symptom assessments.

A total of 112 patient-physician pairs completed at least one question on the SNOT-22. More than half of patients reported ear fullness, thick nasal discharge, sneezing, reduced concentration, reduced productivity, waking up tired, and feeling frustrated/restless/irritable. The most significant severity discrepancy was for thick nasal discharge, reported as “severe” or symptoms “as bad as it can be” by 20.7% of patients versus 1.1% of physicians. The symptoms most commonly reported as at least severe by the patient and physician were nasal blockage (47.7% vs. 19.3%), post-nasal discharge (26.0% vs. 6.0%), decreased sense of smell/taste (42.5% vs. 13.1%), runny nose (26.1% vs. 5.7%), and need to blow nose (13.8% vs. 2.3%).

The researchers said that although there is a high level of patient-physician agreement when it comes to recognizing typical nasal polyp symptoms, physicians tend to underestimate symptom severity. Physicians also may not notice some of the less common symptoms, “highlighting the hidden burden existing therapies may not currently address,” the study authors stated.

https://www.jacionline.org/article/S0091-6749(19)32181-5/fulltext