Patient-Reported Outcome Measures in Rhinitis and Chronic Rhinosinusitis

Abstract

Patient-Reported Outcome Measures (PROMs) are valuable in the assessment and management of rhinitis and chronic rhinosinusitis [CRS]. They measure outcomes which may include symptoms, disease control, well-being, and health-related quality of life (QOL). PROMS for rhinitis and rhinosinusitis are often used before and after an intervention, e.g., medication, therapeutic procedure or, in allergic rhinitis (AR), allergen immunotherapy. Although widely used in clinical trials for AR and conjunctivitis, symptom score PROMs are less validated than disease control or QOL measures. The best validated PROM for AR is the RQLQ (Rhinitis Quality of Life Questionnaire), but there is no universally accepted criterion standard for symptom and disease control PROMs. For CRS, at least 15 different criteria have been used to assess disease control in clinical studies, but what CRS disease control means and how it should be measured are concepts in evolution. The most used QOL measure for CRS is the SNOT-22 Sinonasal Outcome Test (SNOT-22). The use of PROMs to support clinical decisions and for shared decision making for rhinitis and rhinosinusitis still has many challenges, including selection of the preferred instrument, when and how to administer, the impact of co-morbidities, and questionnaire fatigue for both patient and provider.