{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:50:51Z","timestamp":1789541451681,"version":"build-2803163510"},"reference-count":27,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/501100007602","name":"Programme Grants for Applied Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007602","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,1,24]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore patient views and perspectives of current management of chronic rhinosinusitis (CRS) in primary and secondary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Semistructured qualitative telephone interviews as part of the MACRO programme (Defining best Management for Adults with Chronic RhinOsinusitis).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary care and secondary care ear, nose and throat outpatient clinics in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Twenty-five patients consented to in-depth telephone interviews. Transcribed recordings were managed using NVivo software and analysed using inductive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CRS has a significant impact on patients\u2019 quality of life, affecting their ability to work effectively, their social interactions and daily living. Patients seek help when symptoms become unmanageable, but can become frustrated with the primary care system with difficulties obtaining an appointment, and lack of continuity of care. Patients perceive that general practitioners can be dismissive of CRS symptoms, and patients often prioritise other concerns when they consult. Health system barriers and poor communication can result in delays in accessing appropriate treatment and referral. Adherence to intranasal steroids is a problem and patients are uncertain about correct technique. Nasal irrigation can be time-consuming and difficult for patients to use. Secondary care consultations can appear rushed, and patients would like specialists to take a more \u2018holistic\u2019 approach to their management. Surgery is often considered a temporary solution, appropriate when medical options have been explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients are frustrated with the management of their CRS, and poor communication can result in delays in receiving appropriate treatment and timely referral. Patients seek better understanding of their condition and guidance to support treatments decisions in light of uncertainties around the different medical and surgical options. Better coordinated care between general practice and specialist settings and consistency of advice has the potential to increase patient satisfaction and improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-022644","type":"journal-article","created":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T16:15:57Z","timestamp":1556036157000},"page":"e022644","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":52,"title":["Chronic rhinosinusitis: a qualitative study of patient views and experiences of current management in primary and secondary care"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4602-9805","authenticated-orcid":false,"given":"Jane","family":"Vennik","sequence":"first","affiliation":[{"name":"Primary Care and Population Sciences, University of Southamption, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Eyles","sequence":"additional","affiliation":[{"name":"Primary Care and Population Sciences, University of Southamption, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Thomas","sequence":"additional","affiliation":[{"name":"Primary Care and Population Sciences, University of Southamption, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Hopkins","sequence":"additional","affiliation":[{"name":"ENT, Guys Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Little","sequence":"additional","affiliation":[{"name":"Primary Care and Population Sciences, University of Southamption, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Blackshaw","sequence":"additional","affiliation":[{"name":"EvidENT, University College London Ear Institute, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Schilder","sequence":"additional","affiliation":[{"name":"EvidENT, University College London Ear Institute, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imogen","family":"Savage","sequence":"additional","affiliation":[{"name":"EvidENT Patient Panel, University College London Ear Institute, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-3236","authenticated-orcid":false,"given":"Carl M","family":"Philpott","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia, Norwich, UK"},{"name":"Ear, Nose and Throat, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,23]]},"reference":[{"key":"2025121410010639000_9.4.e022644.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2011.02646.x"},{"key":"2025121410010639000_9.4.e022644.2","unstructured":"Hopkins C , Holy C , Philpott C . Care pathway of patients with chronic rhinosinusitis in the UK. British Academic Conference in Otorhinolaryngology. Liverpool, 2015."},{"key":"2025121410010639000_9.4.e022644.3","unstructured":"Hospital Episode Statistics [Internet]. Department of Health, 2013. http:\/\/www.hesonline.nhs.uk\/Ease\/servlet\/ContentServer?siteID=1937"},{"key":"2025121410010639000_9.4.e022644.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(95)70152-4"},{"key":"2025121410010639000_9.4.e022644.5","doi-asserted-by":"publisher","DOI":"10.1023\/A:1016705615207"},{"key":"2025121410010639000_9.4.e022644.6","doi-asserted-by":"crossref","first-page":"2341","DOI":"10.1002\/lary.24027","article-title":"Patient-centered decision making in the treatment of chronic rhinosinusitis","volume":"123","author":"Soler","year":"2013","journal-title":"Laryngoscope"},{"key":"2025121410010639000_9.4.e022644.7","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/coa.12462","article-title":"Chronic rhinosinusitis: patient experiences of primary and secondary care - a qualitative study","volume":"41","author":"Erskine","year":"2016","journal-title":"Clinical Otolaryngology"},{"key":"2025121410010639000_9.4.e022644.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2007.07.013"},{"key":"2025121410010639000_9.4.e022644.9","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-022643","article-title":"Management strategies for chronic rhinosinusitis: a qualitative study of GP and ENT specialist views of current practice in the UK","volume":"8","author":"Vennik","year":"2018","journal-title":"BMJ Open"},{"key":"2025121410010639000_9.4.e022644.10","unstructured":"The MACRO programme. Available: https:\/\/www.themacroprogramme.org.uk\/ (accessed Jan 2018)."},{"key":"2025121410010639000_9.4.e022644.11","doi-asserted-by":"publisher","DOI":"10.4193\/Rhino50E2"},{"key":"2025121410010639000_9.4.e022644.12","unstructured":"Hammersley M . What\u2019s Wrong With Ethnography? Methodological Explorations. London: Routledge, 1992."},{"key":"2025121410010639000_9.4.e022644.13","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2025121410010639000_9.4.e022644.14","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s40463-016-0149-z","article-title":"Exploring the psychological morbidity of waiting for sinus surgery using a mixed methods approach","volume":"45","author":"Tsang","year":"2016","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"2025121410010639000_9.4.e022644.15","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1002\/lio2.87","article-title":"Impact of sinonasal disease on depression, sleep duration, and productivity among adults in the United States","volume":"2","author":"Zhou","year":"2017","journal-title":"Laryngoscope Investig Otolaryngol"},{"key":"2025121410010639000_9.4.e022644.16","doi-asserted-by":"crossref","first-page":"113","DOI":"10.4193\/Rhin16.111","article-title":"Chronic rhinosinusitis and mood disturbance","volume":"55","author":"Erskine","year":"2017","journal-title":"Rhinology"},{"key":"2025121410010639000_9.4.e022644.17","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1046\/j.1365-2273.2000.00417.x","article-title":"Patient and physician perspectives on the impact and management of perennial and seasonal allergic rhinitis","volume":"25","author":"Scadding","year":"2000","journal-title":"Clin Otolaryngol Allied Sci"},{"key":"2025121410010639000_9.4.e022644.18","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1056\/NEJMra050100","article-title":"Adherence to medication","volume":"353","author":"Osterberg","year":"2005","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025121410010639000_9.4.e022644.19","first-page":"Cd011996","article-title":"Intranasal steroids versus placebo or no intervention for chronic rhinosinusitis","volume":"115","author":"Chong","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121410010639000_9.4.e022644.20","first-page":"Cd011993","article-title":"Different types of intranasal steroids for chronic rhinosinusitis","volume":"25","author":"Chong","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121410010639000_9.4.e022644.21","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1111\/coa.13012","article-title":"Current use of baseline medical treatment in chronic rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES)","volume":"43","author":"Philpott","year":"2018","journal-title":"Clin Otolaryngol"},{"key":"2025121410010639000_9.4.e022644.22","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-017130","article-title":"\u2019Well, it literally stops me from having a life when it\u2019s really bad': a nested qualitative interview study of patient views on the use of self-management treatments for the management of recurrent sinusitis (SNIFS trial)","volume":"7","author":"Leydon","year":"2017","journal-title":"BMJ Open"},{"key":"2025121410010639000_9.4.e022644.23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2753.2010.01369.x"},{"key":"2025121410010639000_9.4.e022644.24","doi-asserted-by":"crossref","first-page":"600","DOI":"10.3109\/02770903.2014.995308","article-title":"Managing chronic rhinosinusitis and respiratory disease: a qualitative study of triggers and interactions","volume":"52","author":"Erskine","year":"2015","journal-title":"Journal of Asthma"},{"key":"2025121410010639000_9.4.e022644.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2007.11.001"},{"key":"2025121410010639000_9.4.e022644.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2011.02709.x"},{"key":"2025121410010639000_9.4.e022644.27","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1007\/s11882-010-0096-0","article-title":"Rhinosinusitis and asthma: a link for asthma severity","volume":"10","author":"Bachert","year":"2010","journal-title":"Curr Allergy Asthma Rep"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-022644","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T18:01:14Z","timestamp":1765735274000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-022644"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,4,23]]},"published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1136\/bmjopen-2018-022644"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-022644","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}