title: Rhinosinusitis treatment protocol: changing provider habits in primary care.
abstract: OBJECTIVE
  Sinus infections are common and represent a high cost to the health care industry. Clinical protocols can be used to develop cost-effective treatment strategies. Our objective was to show that a protocol for rhinosinusitis can change provider practice patterns in primary care.
  
  
  METHODS
  We used a literature search, survey of primary caregivers, and chart review from an academic health center to define and document current patterns. A protocol was developed and evaluated using the Rhinosinusitis Disability Index.
  
  
  RESULTS
  Survey and chart review identified that primary caregivers do not elicit a detailed history for rhinosinusitis. Protocol use increased this to 100%. First-line antibiotic therapy was used for only 49.4% of the patients before protocol use and for 68.5% after protocol use. Patients felt better after treatment 84.1% of the time; the Rhinosinusitis Disability Index could not measure improvement.
  
  
  CONCLUSIONS
  Provider practice patterns were positively influenced by use of the protocol.
  
  
  CONCLUSIONS
  Clinical protocols should be developed to direct provider treatment practices.
authors.affiliation: Department of Surgery Otolaryngology, University of Missouri Columbia, 65212, USA. kinneyw@health.missouri.edu
authors.forename: William C
authors.initials: WC
authors.lastname: Kinney
mesh_terms: D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D005260:Female; D005544:Forecasting; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000191:economics / Q000592:standards*; D011336:Probability; D012220:Rhinitis / Q000191:economics / Q000628:therapy*; D012852:Sinusitis / Q000191:economics / Q000628:therapy*; D014481:United States