Refractory Chronic Rhinosinusitis Carries High Productivity Cost

Clinical Question

How much is lost in annual productivity costs for a patient with refractory chronic rhinosinusitis (RCRS), and what is the relationship between productivity costs and RCRS-specific characteristics?

Background: Patients with RCRS suffer several negative health consequences, including reduced quality of life, poor sleep, and increased body pain. These effects can lead to work absences, reduced work performance, and lost leisure household time. Accurate disease-specific costs must include direct and indirect costs for a societal perspective. The relationship between CRS-specific characteristics and degree of productivity costs must also be evaluated.

Study design: Prospective, multi-institutional, observational cohort study.

Setting: Patients were enrolled at four tertiary level rhinology clinics: Medical University of South Carolina, University of Calgary, Stanford University, and Oregon Health and Science University.

Synopsis: A total of 55 RCRS patients were enrolled. Lost productive time (LPT) was defined as the per-person workdays lost due to RCRS. Household productivity loss was calculated by time per day used at home to care for sinuses. Comorbid characteristics included nasal polyps and asthma. The mean annual absenteeism LPT was 24.6 days per patient; LPT when patients were present was 38.8 workdays per patient. The overall annual LPT from both was 63.4 paid workdays missed per patient. Patients reported a mean of 29 minutes per day caring for their sinus disease, with a mean of 21.2 household days lost per year. Productivity costs related to paid work LPT were $8,150.07 per year, and those related to household LPT were $1,927 per year. There was no association between RCRS with or without polyposis and CRS with or without asthma. There was a significant correlation between productivity cost and degree of disease-specific quality-of-life impairment, and between age and productivity costs. Limitations included the small number of patients, a small cohort of the overall CRS population, and a potential risk of recall bias.

Bottom line: The annual productivity cost associated with RCRS is $10,077.07 per patient, providing a strong incentive to optimize treatment protocols.

Citation: Rudmik L, Smith TL, Schlosser RJ, Hwang PH, Mace JC, Soler ZM. Productivity costs in patients with refractory chronic rhinosinusitis. Laryngoscope. 2014;124:2007-2012.

—Reviewed by Amy Eckner