NEW CANADIAN TREATMENT GUIDELINES ARE FIRST IN THE WORLD TO COMPREHENSIVELY ADDRESS CHRONIC RHINOSINUSITIS
~ Chronic Rhinosinusitis Seen as Emerging Disease Entity While Acute Bacterial Rhinosinusitis Still Connected to Antibiotic Resistance ~
TORONTO, March 16 /CNW/ - New Canadian Clinical Practice Guidelines for Acute and Chronic Rhinosinusitis are the first in the world to contain an evidence-based strategy for managing and treating chronic rhinosinusitis (CRS), a disease that is emerging as an area of unmet medical need. The Guidelines, prepared by leading Canadian multidisciplinary medical experts, are co-published in the Allergy, Asthma & Clinical Immunology (http://www.aacijournal.com/content/7/1/2) and the Journal of Otolaryngology-Head and Neck Surgery.
"Sinusitis is an extremely common condition that is important not only in terms of patient suffering, but also because of the significant economic costs associated with it and the frequent use of antibiotics to manage the condition," said Dr. Martin Desrosiers, lead guidelines author, and with the Division of Otolaryngology Head and Neck Surgery Centre, University of Montréal. "For example, the burden of antibiotic therapy and sinusitis is considerable - approximately 25 per cent of prescriptions dispensed for oral antibiotics are for the management of acute bacterial rhinosinusitis, or ABRS."
"With this Guidelines effort, one of our objectives is to reduce unwarranted use of antibiotics for the management of sinusitis in order to minimize risks of complications and development of antibody resistance in society," said Dr. Desrosiers. "With its updates on ABRS and the new focus on CRS, these Guidelines review current medical evidence and address controversies in order to afford physicians up-to-date information on diagnosing and treating this condition."
Supporting Physicians to Change Prescribing Patterns in CRS
For the first time, the diagnosis and management of CRS is established within treatment guidelines. "Initially considered a chronic bacterial infection, CRS is now recognized as its own clinical entity, and as such, it is no longer reasonable to manage CRS as a prolonged version of ABRS," said Dr. Paul Keith, Department of Medicine, Division of Allergy and Clinical Immunology, McMaster University, Hamilton. "The need to define specific therapeutic strategies adapted to the pathogenesis was long overdue - the Guidelines now recognize, and set out, more appropriate treatment options and approaches that are required in today's environment."
CRS - Responding to an Unmet Medical Need
"CRS is a highly-prevalent disease that is increasing in frequency and has a significant impact on quality of life. Primary care practitioners are confronted with this disease on a daily basis so the availability of new evidence-based guidance and support will help provide the best patient outcomes," said Dr. Gerald Evans, an Associate Professor in the Division of Infectious Diseases, Department of Medicine, and Departments of Microbiology & Immunology and Pathology & Molecular Medicine, Queen's University and Kingston General Hospital in Kingston, Ontario. "Guidance for managing patients with CRS will help those community practitioners who are less experienced in this area, offer optimal care to their patients. In turn, this means patients receive faster care and symptom relief from their primary care provider rather than waiting in pain for a referral to a specialist."
A recent Canadian study described the impact of CRS on patients and healthcare utilization. Patients with CRS had a health status similar to patients with arthritis, cancer, asthma, and inflammatory bowel disease. Compared with people without CRS, those with CRS reported more days spent bedridden and more visits to family physicians, alternative healthcare providers, and mental health experts. These findings underscore the significant impact of this disease on patient quality of life, as well as costs of care to patients and society.
Comprehensive Education Program to be Launched
Within the Guidelines development effort, learning tools are incorporated such as expert opinions, algorithms and mnemonics for immediate practical applications for the physician. To support the educational effort of rhinosinusitis, a new web site - www.sinuscanada.com - has been created to serve as a comprehensive resource on these conditions, including videos on learning how to conduct proper nasal examinations and slide kits.
Also to support the dissemination of the Guidelines and provide ongoing updates, a Canadian Rhinosinusitis Best Practices and Standards Working Group has been established comprised of originating Guidelines stakeholder organizations: Association of Medical Microbiology and Infectious Disease Canada; Canadian Association of Emergency Physicians; Canadian Society of Allergy and Clinical Immunology; Canadian Society of Otolaryngology - Head and Neck Surgery; and The Family Physicians Airway Group of Canada.
Rhinosinusitis is a frequently occurring disease, with significant impact on quality of life and health care spending, and economic impact in terms of absenteeism and productivity. According to the most recent data, it is estimated that 2.6 million cases of rhinosinusitis occur annually in Canada and 2.89 million prescriptions are dispensed for ABRS or CRS - approximately two-thirds for ABRS and one-third for CRS.
A survey of Canadian households reported the prevalence of CRS to be 5%. The prevalence was higher in women compared with men (5.7% v. 3.4% for subjects aged ≥12 years) and increased with age.For further information:
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GCI Group (Canada)