Patient knowledge in chronic rhinosinusitis with nasal polyps: a multicentre cross-sectional study

To characterize disease-related knowledge in chronic rhinosinusitis with nasal polyps (CRSwNP) and identify factors associated with higher scores across clinically relevant domains.

In this multicentre cross-sectional study, adults with confirmed CRSwNP completed the 14-item SKQ-Pol and SNOT-22 during routine outpatient care. The continuous percentage score was the primary adjusted outcome. Exploratory analyses assessed item performance, reliability, internal structure, and hypothesis-based construct relationships. Multivariable models included a hospital random intercept; 50%, 60%, and 70% thresholds were examined only in sensitivity analyses.

Among 791 participants from 23 hospitals, the median score was 35.7% (IQR 21.4-50.0); 12.0% scored at least 60%. Internal consistency was moderate (KR-20 = 0.670; 95% CI 0.63-0.70), and internal-structure analyses did not support a simple unidimensional scale or reliable subscales. In the primary adjusted model, biologic treatment (+ 8.02% points, 95% CI 5.03-11.01), university education (+ 8.27, 4.88-11.65), postgraduate education (+ 8.02, 3.70-12.34), longer disease duration (+ 0.36 per year, 0.20-0.53), and previous endoscopic sinus surgery (+ 1.94 per procedure, 0.72-3.16) were associated with higher scores. Male sex (- 3.67, - 6.12 to - 1.22) and older age (- 0.22 per year, - 0.32 to - 0.12) were associated with lower scores. Sensitivity analyses were directionally consistent.

Knowledge across the assessed CRSwNP domains was generally low. The identified content gaps and associated patient profiles may inform the prospective development and evaluation of targeted educational strategies.