title: Managing chronic rhinosinusitis and respiratory disease: a qualitative study of triggers and interactions.
abstract: OBJECTIVE
  The aim of this analysis is to explore views of patients with chronic rhinosinusitis (CRS) about of the aetiology of their respiratory symptoms and the relationship between upper and lower respiratory symptoms.
  
  
  METHODS
  This study is part of a larger mixed methods study investigating the epidemiology of CRS, which comprises a questionnaire study of patients with CRS and controls and a qualitative study of 21 patients with CRS. Semi structured qualitative interviews were undertaken with these patients; 11 males and 10 females. Twelve patients had asthma. Patients were recruited with a tertiary outpatient rhinology clinic. Interviews were transcribed verbatim and analysed using thematic analysis, using Nvivo software (QSR International, Melbourne, Australia). Several important and recurring themes were highlighted.
  
  
  RESULTS
  Patients described many perceived triggering factors and an interaction between upper and lower respiratory tract symptoms. They felt that their symptoms could be managed more holistically.
  
  
  CONCLUSIONS
  Concerns about triggers of respiratory symptoms and interactions between upper and lower respiratory symptoms are of significant concern to patients. These should be appropriately managed and acknowledged in formal treatment pathways, for example, through the use of combined ENT/respiratory clinics.
authors.affiliation: a Norwich Medical School, Norwich Research Park, University of East Anglia , Norwich , UK.
authors.forename: Sally E
authors.initials: SE
authors.lastname: Erskine
authors.forename: Caitlin
authors.initials: C
authors.lastname: Notley
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Wilson
authors.forename: Carl M
authors.initials: CM
authors.lastname: Philpott
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D004032:Diet; D004777:Environment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D036301:Qualitative Research; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D012220:Rhinitis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D012852:Sinusitis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology
keywords: Allergy; clinical practice guideline; patient care management; respiratory tract diseases; rhinitis