{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:45:17Z","timestamp":1789170317538,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,12,11]],"date-time":"2017-12-11T00:00:00Z","timestamp":1512950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Anthony Long Trust"},{"name":"Bernice Bibby Trust"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>According to clinical and comissioning guidelines for chronic rhinosinusitis (<jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content>), patients being referred to secondary care should have failed primary medical treatment with nasal douching (<jats:styled-content style=\"fixed-case\">ND<\/jats:styled-content>) and intranasal corticosteroids (<jats:styled-content style=\"fixed-case\">INCS<\/jats:styled-content>). The study objectives were to identify the rate of specific medical therapy in <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content> patients and establish any differences in medication use, for both <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content> and associated medical conditions, between <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content> phenotypes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>Case\u2013control study in a secondary care setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participant\u2010reported study\u2010specific questionnaire capturing free text data on current medication use at the time of study entry. Qualitative interviews with 21 participants also explored their experience of <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content> and its management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Particpants<\/jats:title><jats:p>Patients both without (<jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content>s<jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>s) and with polyps (<jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content>w<jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Reported use of <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content>\u2010related and non\u2010related medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Within a total of 1243 <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content> participants, current <jats:styled-content style=\"fixed-case\">INCS<\/jats:styled-content> usage was low (18% in <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content>w<jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>s, 12% in <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content>s<jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>s); <jats:styled-content style=\"fixed-case\">ND<\/jats:styled-content> was being performed by only 1% of all participants. Bronchodilators and inhaled corticosteroids use was significantly higher in <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content>w<jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>s participants (<jats:italic>P<\/jats:italic> &lt; .0001). Antidepressant use was significantly higher in <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content>s<jats:styled-content style=\"fixed-case\">NP<\/jats:styled-content>s (14% vs 7%, <jats:italic>P<\/jats:italic> &lt; .0002). There were no significant regional variations in rates of <jats:styled-content style=\"fixed-case\">INCS<\/jats:styled-content> use, nor any significant influence of social deprivation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The current use of baseline medical therapy in <jats:styled-content style=\"fixed-case\">CRS<\/jats:styled-content> appears to be very low, representing a combination of poor patient compliance, possible ineffectiveness of treatment and a lack of familiarity with current guidelines amongst general practitioners and some <jats:styled-content style=\"fixed-case\">ENT<\/jats:styled-content> specialists. Work is needed to disseminate guidelines to all practitioners involved and reduce unnecessary burden on existing healthcare resources for this common condition by ensuring timely referral and definitive management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13012","type":"journal-article","created":{"date-parts":[[2017,10,21]],"date-time":"2017-10-21T02:46:41Z","timestamp":1508554001000},"page":"509-524","source":"Crossref","is-referenced-by-count":21,"title":["Current use of baseline medical treatment in chronic rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES)"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-3236","authenticated-orcid":false,"given":"C.","family":"Philpott","sequence":"first","affiliation":[{"name":"James Paget University Hospital NHS Foundation Trust Gorleston UK"},{"name":"Norwich Medical School University of East Anglia Norfolk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Erskine","sequence":"additional","affiliation":[{"name":"James Paget University Hospital NHS Foundation Trust Gorleston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia Norfolk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Guys &amp; St Thomas Hospital NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Kara","sequence":"additional","affiliation":[{"name":"County Durham &amp; Darlington NHS Foundation Trust Darlington UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Farboud","sequence":"additional","affiliation":[{"name":"Wrexham Maelor Hospital Wrexham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Salam","sequence":"additional","affiliation":[{"name":"Ipswich Hospital NHS Foundation Trust Ipswich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Robertson","sequence":"additional","affiliation":[{"name":"Queen Elizabeth University Hospital Campus Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Almeyda","sequence":"additional","affiliation":[{"name":"Royal Berkshire NHS Foundation Trust Reading UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.N.","family":"Kumar","sequence":"additional","affiliation":[{"name":"Wrightington Wigan and Leigh NHS Foundation Trust Wigan UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Anari","sequence":"additional","affiliation":[{"name":"Heart of England NHS Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Ray","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHSFT Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Cathcart","sequence":"additional","affiliation":[{"name":"Cumberland Infirmary Carlisle UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Carrie","sequence":"additional","affiliation":[{"name":"Freeman Hospital Newcastle UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Derriford Hospital Plymouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Clark","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia Norfolk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Primary Care and population Sciences University of Southampton Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the CRES group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,11]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"1","article-title":"European position paper on rhinosinusitis and nasal polyps 2012","volume":"3","author":"Fokkens WJ","year":"2012","journal-title":"Rhinol Suppl"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2011.02646.x"},{"key":"e_1_2_13_4_1","unstructured":"HopkinsC HolyCE&PhilpottCM.Care pathway of patients with chronic rhinosnusitis in the UK. 2015. 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