Burden of Nasal Polyps in the United States

Elisabeth H Ference; Sheila R Reddy; Ryan Tieu; Sohum Gokhale; Siyeon Park; Jason LeCocq

doi:10.1177/2473974X20950727

Burden of Nasal Polyps in the United States

OTO Open. 2020 Sep 1;4(3):2473974X20950727. doi: 10.1177/2473974X20950727. eCollection 2020 Jul-Sep.

Authors

Elisabeth H Ference¹, Sheila R Reddy², Ryan Tieu², Sohum Gokhale², Siyeon Park³, Jason LeCocq⁴

Affiliations

¹ Caruso Department of Otolaryngology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
² Partnership for Health Analytic Research, LLC, Beverly Hills, California, USA.
³ Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA.
⁴ Novartis Pharmaceuticals, East Hanover, New Jersey, USA.

Abstract

Objective: To investigate the clinical and health care burden of chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) in the United States.

Study design: Retrospective, cross-sectional design with analyses of patient visits from 2 databases.

Setting: National Ambulatory Medical Care Survey (NAMCS, 2012-2016) and State Ambulatory Surgery and Services Databases (SASD, 2012-2015) in available states.

Methods: In each analysis, we identified patients (≥18 years old) with a diagnosis of CRSwNP (ICD-9-CM: 471.x; ICD-10-CM: J33.x) in the visit record during the study period. CRS patients without polyps (CRSsNP: ICD-9-CM: 473.x, ICD-10-CM: J32.x; without CRSwNP codes) were identified for comparison. In the SASD, we focused on visits involving relevant sinus procedures. Outcomes included comorbidities, diagnostic testing, and prescribed medication (NAMCS) and surgery visit characteristics (SASD).

Results: We identified 2272 NAMCS records from physician offices (183 CRSwNP, 2089 CRSsNP). Most visits were for patients aged <65 years (78.8%, 80.6%) and privately insured (67.7%, 61.5%); CRSwNP visits had a male majority (56.3%, 35.4%). CRSwNP vs CRSsNP visits more often reported asthma (40.2%, 10.3%), allergic rhinitis (14.0%, 8.7%), and congestion (22.0%, 21.1%), with the use of glucocorticoids (21.0%, 17.7%) and nasal allergy medication (26.2%, 10.2%). In the SASD, 427,306 surgery visits were identified (71,195 CRSwNP, 356,111 CRSsNP); demographics were similar to NAMCS. CRSwNP surgeries involved more sinus types (59.3%, 41.4%). Surgeries were mostly elective (>99%) and completed quickly (<2 hours), without perioperative complications (>99%), followed by routine discharge (>91%); follow-up visits were common (14.9%, 13.9%).

Conclusion: CRSwNP compared to CRSsNP patients have a distinct clinical experience, with moderately higher medication need and more extensive surgery.

Keywords: administrative claims; burden of illness; chronic rhinosinusitis; health care utilization; nasal polyps; retrospective analysis.