Gokani Shyam Ajay, Clark Allan, Javer Amin, Philpott Carl
Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
St Paul's Sinus Centre, Vancouver, BC V6Z 1Y6, Canada.
J Clin Med. 2023 Aug 18;12(16):5381. doi: 10.3390/jcm12165381.
This study aimed to evaluate factors that may predispose patients to not adhere to prescribed medication after endoscopic sinus surgery (ESS) and to compare SNOT-22 scores at 0-12 months post-operatively between adherent and non-adherent patients. CRS patients who underwent ESS between 2012 and 2016 were recruited to this retrospective cohort study. Adherence was assessed through a questionnaire and review of medical notes. Ninety-four participants were included (61% male, mean age 60). Of those, 66% did not adhere to their prescribed post-operative CRS medication timing or dosage. The most common reason for non-adherence was improvement of symptoms (17%), followed by deterioration of symptoms (11%) and side effects (10%). Post-operative SNOT-22 scores were lowest for non-intentionally non-adherent (NINA) participants with a mean of 10.5 [95% CI: 7.47-13.5], compared to 25.0 for intentionally non-adherent (INA) [95% CI: 17.6-32.4] and 17.7 for adherent patients [95% CI: 13.7-21.7], = 0.01. This study identifies that almost two-thirds of patients are not compliant with CRS medications after ESS. NINA participants reported lower post-operative SNOT-22 scores compared to INA and adherent participants. Future studies should focus on educating patients to continue with medications post-operatively despite an initial improvement in symptoms.
本研究旨在评估可能使患者在内镜鼻窦手术(ESS)后不坚持遵医嘱用药的因素,并比较术后0至12个月依从性和非依从性患者的鼻窦鼻相关生活质量量表(SNOT-22)评分。2012年至2016年间接受ESS的慢性鼻-鼻窦炎(CRS)患者被纳入这项回顾性队列研究。通过问卷调查和病历审查评估依从性。纳入94名参与者(61%为男性,平均年龄60岁)。其中,66%的患者未遵守术后CRS药物的服用时间或剂量。最常见的不依从原因是症状改善(17%),其次是症状恶化(11%)和副作用(10%)。非故意不依从(NINA)参与者术后SNOT-22评分最低,平均为10.5[95%置信区间:7.47-13.5],而故意不依从(INA)参与者为25.0[95%置信区间:17.6-32.4],依从性患者为17.7[95%置信区间:13.7-21.7],P = 0.01。本研究发现,几乎三分之二的患者在ESS后不遵守CRS药物治疗。与INA和依从性参与者相比,NINA参与者术后SNOT-22评分更低。未来的研究应侧重于教育患者,使其即使症状初步改善后仍在术后继续用药。