Development of a therapeutic education program for patients with chronic rhinosinusitis with nasal polyps

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a long-lasting inflammatory disease that affects 1-4% of the population and markedly impairs quality of life, daily functioning, and socio-professional activities. As no curative treatment exists, long-term control relies on strict adherence to maintenance therapy (mainly nasal irrigations and topical corticosteroids). Yet, incorrect techniques and poor adherence remain frequent. Therapeutic patient education (TPE), widely validated in other chronic diseases, strengthens patients' knowledge, self-management skills, and engagement with treatment. Despite its relevance, no structured TPE program has been available for CRSwNP. Our objective was therefore to develop a dedicated therapeutic education program tailored to patients with CRSwNP.

A TPE program was designed in a Tertiary center ENT department. TPE sessions were conducted between February and June 2023. The workshops were developed collaboratively by a multidisciplinary team. At the beginning of each session, patients completed a true/false questionnaire assessing their knowledge of chronic rhinosinusitis with nasal polyps, as well as the SNOT-22 quality of life questionnaire and a therapeutic adherence scale. The knowledge questionnaire was repeated at the end of the session. In addition, standardized demonstrations and practical exercises were integrated to reinforce correct treatment administration. Three months later, patients were asked to complete the SNOT-22 and adherence scale again to assess the long-term impact of the intervention, as well as to evaluate potential changes in symptoms, adherence, and overall disease control.

In a cohort of n = 36 patients, TPE led to a marked improvement in both theoretical and practical knowledge of chronic rhinosinusitis with nasal polyps (CRSwNP). By the end of the sessions, patients demonstrated correct technique for nasal irrigation and corticosteroid spray administration. Patient satisfaction was high, with mean scores exceeding 9/10 for session format and perceived usefulness. Most patients reported improved understanding and greater engagement in their care. Although the reduction in SNOT-22 scores and improvement in treatment adherence at 3 months did not reach statistical significance, both showed favorable trends.

TPE should be more widely implemented in the management of patients with CRSwNP. Our findings indicate that TPE is a well-received and potentially valuable component of care. TPE is highly appreciated by patients and appears to enhance their understanding of the disease, improve quality of life, and support better long-term treatment adherence.