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Rhinosinusitis treatment protocol: changing provider habits in primary care
1Department of Surgery Otolaryngology, University of Missouri Columbia, 65212, USA. kinneyw@health.missouri.edu
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.
Study Design And Setting:
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.
Conclusion:
Provider practice patterns were positively influenced by use of the protocol.
Significance:
Clinical protocols should be developed to direct provider treatment practices.