Clinic of Allergy & Asthma, Medical University Sofia, Bulgaria.
Ann Allergy Asthma Immunol. 2012 Apr;108(4):232-6. doi: 10.1016/j.anai.2012.02.009.
The proportion of patients visiting general practitioners (GPs), otorhinolaryngologists (ORLs), and allergologists (ALRGs) for nasal complaints is unknown but important in estimating the number of subjects with nasal symptoms bothersome enough to warrant physician consultations and assessing nasal pathological conditions' burden on a national health care system.
The Symptoms of Nasal Inconvenience Fact Finding (SNIFF) survey was developed to (1) assess incidence of physician visits attributable to nasal complaints; (2) characterize patients' nasal conditions; and (3) outline differences across physician categories.
The SNIFF survey was completed over 20 days by Bulgarian GPs, ORLs, and ALRGs whom patients consulted for nasal symptoms. Survey forms differentiated type and severity of patients' conditions according to Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines and ranked bothersome symptoms. Smell impairment, comorbidities, and prescription practices were documented.
Sixty-nine physicians (30 GPs, 8 ORLs, 31 ALRGs) completed 1,685 surveys. The proportion of patients with nasal symptoms over the total patients seen was 15.7%: ALRGs, 18.0%; GPs, 14.6%; ORLs, 13.1%. Patients were classified as having intermittent (38.8%) or persistent (61.2%) rhinitis, with most having moderate/severe symptoms (94.4%). Congestion was the leading symptom in 59.1%. Smell was impaired in 69.8% of patients, asthma was present in 21.4%, and cough in 62.9%. ALRGs were more likely to diagnose and manage patients per ARIA guidelines than were ORLs or GPs.
The SNIFF survey results demonstrate congestion's role as a leading symptom motivating patients to seek medical advice. SNIFF also uncovered differences in practices among different categories of health care providers.
因鼻部不适就诊于全科医生（GPs）、耳鼻喉科医生（ORLs）和过敏科医生（ALRGs）的患者比例尚不清楚，但对于估计因鼻部症状而需要就诊的患者数量以及评估鼻部病理状况对国家卫生保健系统的负担至关重要。
鼻不适症状发现调查（SNIFF）旨在：（1）评估因鼻部症状而就诊的患者比例；（2）描述患者的鼻部状况；（3）阐明不同医生类别的差异。
保加利亚的 GPs、ORLs 和 ALRGs 在 20 天内完成了 SNIFF 调查，患者因鼻部症状而向这些医生就诊。调查问卷根据过敏性鼻炎及其对哮喘的影响（ARIA）指南区分了患者病情的类型和严重程度，并对困扰症状进行了分级。嗅觉障碍、合并症和处方实践情况也被记录下来。
69 名医生（30 名全科医生、8 名耳鼻喉科医生、31 名过敏科医生）完成了 1685 份调查问卷。有鼻部症状的患者占就诊总人数的 15.7%：过敏科医生占 18.0%；全科医生占 14.6%；耳鼻喉科医生占 13.1%。患者被分为间歇性（38.8%）或持续性（61.2%）鼻炎，大多数患者有中重度症状（94.4%）。鼻塞是最常见的症状（59.1%）。69.8%的患者嗅觉受损，21.4%的患者有哮喘，62.9%的患者有咳嗽。与 ORLs 或 GPs 相比，ALRGs 更有可能根据 ARIA 指南诊断和治疗患者。
SNIFF 调查结果表明，鼻塞是促使患者寻求医疗建议的主要症状。SNIFF 还揭示了不同类别的医疗保健提供者之间的实践差异。
