title: High costs and burden of illness in acute rhinosinusitis: real-life  treatment patterns and outcomes in Swedish primary care.
abstract: BACKGROUND
  Few studies have investigated the impact of acute rhinosinusitis on disease-specific quality of life, and disease costs have not been studied previously in Scandinavia.
  
  
  OBJECTIVE
  To study symptoms, treatment patterns, quality of life and costs in adults with acute rhinosinusitis.
  
  
  METHODS
  This was an observational study in primary care. Patients aged 18-80 years seeking care for acute rhinosinusitis were evaluated using the Major Symptom Score (MSS) on days 0 and 15. Recommended and used treatments, quality of life and costs were assessed by questionnaires including EQ-5D™ and a visual analogue scale (VAS) on the same days.
  
  
  RESULTS
  150 patients were enrolled; 143 provided follow-up data. The proportion of MSS responders was 91%. Mean MSS decreased from 8.4 on day 0 (N = 150) to 1.9 on day 15 (N = 143). Patients reporting pain/discomfort and problems with usual activities decreased from 88.4% to 31.5% and from 43.2% to 1.4%, respectively, and mean VAS increased from 58.7 to 79.5. Intranasal corticosteroids were the most recommended and/or prescribed drugs. Total cost for an episode was 10,260 SEK (€1,102), of which 75% were indirect costs.
  
  
  CONCLUSIONS
  With treatment dominated by intranasal corticosteroids, a high proportion of responders and good symptom relief were seen. Acute rhinosinusitis seems to cause a high burden on quality of life and also a high cost for society.
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Otorhinolaryngology, Karolinska Institute, Stockholm, Sweden. par.stjarne@karolinska.se
authors.forename: Pär
authors.initials: P
authors.lastname: Stjärne
authors.forename: Peter
authors.initials: P
authors.lastname: Odebäck
authors.forename: Björn
authors.initials: B
authors.lastname: Ställberg
authors.forename: Johan
authors.initials: J
authors.lastname: Lundberg
authors.forename: Petter
authors.initials: P
authors.lastname: Olsson
mesh_terms: D000208:Acute Disease; D000281:Administration, Intranasal; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011788:Quality of Life; D012220:Rhinitis / Q000188:drug therapy / Q000191:economics*; D012852:Sinusitis / Q000188:drug therapy / Q000191:economics*; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones