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Recent studies examine the burden of CRSwNP, looking at quality of life in patients and caregivers and assessing how CRSwNP impacts mental health.

“The key symptoms of chronic rhinosinusitis with nasal polyps (CRSwNPs) are complete or partial loss of smell (anosmia or hyposmia), nasal obstruction or congestion, nasal secretion, postnasal drip, and facial pain or pressure, which significantly reduce the [health-related quality of life] of both patients and caregivers,” Luca Malvezzi, MD, and colleagues wrote in Healthcare. “A recent systematic review highlights a gap in research on the burden of CRSwNPs on caregivers, suggesting that this is an area worth exploring.”

Dr. Malvezzi and colleagues also noted that, while there are many treatment options available for CRSwNP, no definitive cure exists. Further, the healthcare costs associated with rhinosinusitis are substantial. Indirect costs are especially relevant and are primarily due to lost productivity, or presenteeism and absenteeism, as nasal congestion results in poor sleep, daytime drowsiness, and reduced productivity or missed work.

However, “very little is known about the daily impact of living with CRSwNPs, particularly how sleep disturbance (quality of sleep and number of restless nights) translates into reduced productivity,” the researchers wrote.

“There is a need for more data on the experiences of caregivers living with patients who have the disease. This study aimed to quantify the burden of CRSwNP on both patients and their caregivers/families.”

Overlapping Symptoms

The analysis included 200 adults with CRSwNP, 100 without CRSwNP (control group), and 50 caregivers of patients with CRSwNP.

The study’s findings reveal that the burden of disease includes sleep impairment, absenteeism and presenteeism, stress, poor self-image, emotional distress, and challenges with treatment responsibilities. These burdens are in addition to all the physical discomforts of the disease. The researchers noted sleep disruption as the most detrimental to quality of life (QOL).

Caregivers were found to share many of the same disease burdens experienced by the people they cared for. Their sleep was disrupted (ie, because of restless sleep and snoring of the partner), they experienced stress, and their daily activities were compromised. Overall, it was reported that the relationship between the patient with CRSwNP and the caregiver created tension.

Specifically, Dr. Malvezzi and colleagues found that:

• Patients and caregivers experienced significantly poorer quality of sleep, with poor sleep occurring on average 72.1 and 51.7 days per year, respectively.
• Impairments in smell and taste significantly influenced patients’ social and working lives: 39.5% reported feeling in danger because of hyposmia and 34.5% because of limited taste.
• CRSwNP alone resulted in an average of 24.7 days of absenteeism and 25.1 days of presenteeism.

VAS, SNOT-22, & A Novel Assessment Tool

 In a separate multicenter observational study published in Healthcare, Carlo Cavaliere, MD, PhD, and colleagues sought to determine the effects of biologic treatment on QOL. The researchers used the Visual Analog Scale (VAS) to determine nasal symptoms and the 22-item Sino-Nasal Outcome Test (SNOT-22) to determine symptom severity and health-related QOL, as well as a newly developed questionnaire meant to examine the psychological health of patients with CRSwNP receiving biologic treatment.

SNOT-22 addresses physical symptoms, health and QOL, and psychological issues, with scores ranging from 0 to 110, while VAS assesses the intensity of specific symptoms on a scale ranging from 0 to 10.

The novel questionnaire included 16 items divided into two parts. The first section included 11 questions and examined mental sensations; the second section included five questions that analyzed physical sensations. The survey focused on key aspects such as loss of self-confidence, anxiety, fatigue, irritability, phobia, and depressive symptoms and aimed to determine whether biologic therapy could influence the emotional well-being of patients and contribute to improvements in their psychological state.

The survey indicated that treatment with biologics not only improves clinical symptoms, but also had a positive impact on mental health, with benefits seen early in treatment.

“The detailed and complex questions in the survey provided valuable insights into the psychological challenges faced by patients with chronic conditions like CRS,” Dr. Cavaliere and colleagues wrote. “These findings emphasize the importance of addressing both physical and mental health in the treatment of CRSwNP, demonstrating that effective therapy can enhance overall well-being. Further research is required to validate and standardize the questionnaire, ensuring its clinical applicability and broader use in patient assessments.”