National Practice Patterns of Antireflux Medication for Chronic Rhinosinusitis.
Antireflux medication has been endorsed as a useful adjunctive therapy for chronic rhinosinusitis, but its use remains controversial.



To determine whether chronic rhinosinusitis is associated with administration of proton pump inhibitors, histamine2-receptor antagonists, antacids, or prokinetic agents; whether practice patterns vary according to visit setting; and whether those patterns vary according to the presence or absence of potentially confounding conditions.



A cross-sectional analysis was performed of data from January 1, 2005, to December 31, 2010, from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, which included 590 772 observations representing 7 191 711 480 ambulatory care visits. Univariate, multivariate, and stratified analyses were performed from January 1, 2005, to December 31, 2010.



Chronic rhinosinusitis.



The probability of receiving antireflux medications was the main measured outcome.



Of 7 191 711 480 ambulatory care visits, those for chronic rhinosinusitis were not more likely to result in the administration of proton pump inhibitors (odds ratio, 1.00; 95% CI, 0.62-1.63; P = .99) or antacids and prokinetic agents (odds ratio, 1.24; 95% CI, 0.30-5.10; P = .77). In addition, patients with chronic rhinosinusitis were less likely to receive histamine2-receptor antagonists than were those without chronic rhinosinusitis, even when adjusted for age, sex, race/ethnicity, visit setting, other antireflux agents, and presence or absence of gastroesophageal reflux, laryngopharyngeal reflux, or allergy diagnoses (odds ratio, 0.25; 95% CI, 0.12-0.57; P = .001).



National practice patterns observed thus far have not favored the use of proton pump inhibitors, histamine2-receptor antagonists, antacids, or prokinetic agents for chronic rhinosinusitis.
Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts.
Sapideh
S
Gilani
Department of Otolaryngology, University of Michigan Medical School, Ann Arbor.
Melissa A
MA
Pynnonen
Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts.
Jennifer J
JJ
Shin
D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000863:Antacids / Q000627:therapeutic use; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000453:epidemiology; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D019538:Health Care Surveys; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012220:Rhinitis / Q000188:drug therapy* / Q000453:epidemiology; D012852:Sinusitis / Q000188:drug therapy* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
D000863:Antacids; D005765:Gastrointestinal Agents; D006633:Histamine Antagonists; D054328:Proton Pump Inhibitors