29 Oct Work Productivity, Quality of Life Factor in Decision For Sinus Surgery
MedicalResearch.com Interview with:
Luke Rudmik, MD
Division of Otolaryngology–Head and Neck Surgery
Department of Surgery
University of Calgary
Calgary, Alberta, Canada
Medical Research: What is the background for this study? What are the main findings?
Dr. Rudmik: The main findings were that patients with chronic sinusitis who have lower impairments in their quality of life can have their work productivity maintained with continuing medical therapy. Although there were no ‘improvements’ in the patients productivity with continuing medical therapy, it is important to note that patients in this study had better baseline quality of life and better baseline productivity compared to patients who chose to receive sinus surgery who had worse baseline quality of life and baseline productivity impairment.
Medical Research: What should clinicians and patients take away from your report?
Dr. Rudmik: The primary implications of this study are that patients can be informed that when they have relatively minimally reduced productivity at work and minimally reduced quality of life from their underlying chronic sinusitis, they can avoid getting worse by continuing with medical therapy. This is contrast to patients who have severe reductions in their baseline productivity and baseline quality of life who would get significant improvements in productivity by choosing to receive endoscopic sinus surgery (See our previously published paper on this topic: Rudmik et al. Productivity Costs Decrease After Endoscopic Sinus Surgery for Refractory Chronic Rhinosinusitis. Laryngoscope 2015).
The take home message is that the decision to choose continued medical therapy or sinus surgery for their underlying chronic sinusitis should be based on the patients preference after they have been adequately informed to their expected outcomes with choosing each intervention. For patients with minimally impaired work place productivity and minimally reduced quality of life, the results from our research suggest that continuing with medical therapy can maintain current level of health. When patients have larger reductions in their work place productivity or quality of life, then sinus surgery may be a better intervention. The decisions for each treatment should involve a shared-decision making process between physician and patient after informing the patient to their expected outcomes and potential risks.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Rudmik: First, we need to validate the findings using a larger cohort. Assuming the results are accurate, we will need to begin developing decision aids to help inform patients to their expected outcomes from either continued medical therapy or sinus surgery and assist them in making a treatment decision that reflects their true preferences.
Rudmik L, Soler ZM, Smith TL, Mace JC, Schlosser RJ, DeConde AS. Effect of Continued Medical Therapy on Productivity Costs for Refractory Chronic Rhinosinusitis.
JAMA Otolaryngol Head Neck Surg.Published online October 29, 2015. doi:10.1001/jamaoto.2015.2321.
Luke Rudmik, MD (2015). Work Productivity, Quality of Life Factor in Decision For Sinus Surgery