Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov;75(11):2867-2878.
doi: 10.1111/all.14408. Epub 2020 Jun 19.

Real-life assessment of chronic rhinosinusitis patients using mobile technology: The mySinusitisCoach project by EUFOREA

Sven F Seys  1   2 , Shana De Bont  3 , Wytske J Fokkens  4 , Claus Bachert  5   6 , Isam Alobid  7 , Manuel Bernal-Sprekelsen  8 , Leif Bjermer  9 , Ina Callebaut  3 , Lars-Olaf Cardell  10 , Sean Carrie  11 , Paolo Castelnuovo  12 , Russell Cathcart  13 , Jannis Constantinidis  14 , Leen Cools  3 , Marjolein Cornet  4 , Gregory Clement  15 , Tony Cox  16 , Lieve Delsupehe  17 , Jaime Correia-de-Sousa  18 , Lauren Deneyer  1 , Geert De Vos  19 , Zuzana Diamant  9   20   21 , Maria Doulaptsi  22 , Simon Gane  23 , Philippe Gevaert  5 , Claire Hopkins  24 , Valérie Hox  25 , Thomas Hummel  26 , Werner Hosemann  27 , Raf Jacobs  28 , Mark Jorissen  3 , Anette Kjeldsen  29 , Basile N Landis  30 , Winde Lemmens  31 , Andreas Leunig  32 , Valerie Lund  23 , Gert Mariën  1 , Joaquim Mullol  7 , Metin Onerci  33 , Susanna Palkonen  34 , Isabel Proano  34 , Emmanuel Prokopakis  22 , Dermot Ryan  35 , Herbert Riechelmann  36 , Pernilla Sahlstrand-Johnson  37 , Sanna Salmi-Toppila  38   39 , Christine Segboer  4 , Kato Speleman  40 , Andreas Steinsvik  41 , Pavol Surda  24 , Peter-Valentin Tomazic  42 , Olivier Vanderveken  43 , Laura Van Gerven  3 , Thibaut Van Zele  5 , Jan Verfaillie  17 , Benedicte Verhaeghe  44 , Kathie Vierstraete  45 , Stephan Vlaminck  46 , Martin Wagenmann  47 , Benoit Pugin  1   2 , Peter W Hellings  2   3   4   5
Affiliations

Real-life assessment of chronic rhinosinusitis patients using mobile technology: The mySinusitisCoach project by EUFOREA

Sven F Seys et al. Allergy. 2020 Nov.

Abstract

Background: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease associated with a substantial personal and socioeconomic burden. Monitoring of patient-reported outcomes by mobile technology offers the possibility to better understand real-life burden of CRS.

Methods: This study reports on the cross-sectional evaluation of data of 626 users of mySinusitisCoach (mSC), a mobile application for CRS patients. Patient characteristics of mSC users were analysed as well as the level of disease control based on VAS global rhinosinusitis symptom score and adapted EPOS criteria.

Results: The mSC cohort represents a heterogeneous group of CRS patients with a diverse pattern of major symptoms. Approximately half of patients reported nasal polyps. 47.3% of all CRS patients were uncontrolled based on evaluation of VAS global rhinosinusitis symptom score compared to 40.9% based on adapted EPOS criteria. The impact of CRS on sleep quality and daily life activities was significantly higher in uncontrolled versus well-controlled patients. Half of patients had a history of FESS (functional endoscopic sinus surgery) and reported lower symptom severity compared to patients without a history of FESS, except for patients with a history of more than 3 procedures. Patients with a history of FESS reported higher VAS levels for impaired smell.

Conclusion: Real-life data confirm the high disease burden in uncontrolled CRS patients, clearly impacting quality of life. Sinus surgery improves patient-reported outcomes, but not in patients with a history of more than 3 procedures. Mobile technology opens a new era of real-life monitoring, supporting the evolution of care towards precision medicine.

Keywords: Mobile health technology; nasal polyp; patient-reported outcome measure; real-world evidence; visual analogue scale.

PubMed Disclaimer

Conflict of interest statement

Dr Alobid reports personal fees from Roche, personal fees from Menarini, personal fees from Mylan, personal fees from Novartis, personal fees from MSD, outside the submitted work. Dr Bachert reports personal fees from Sanofi, GSK, AstraZeneca and Novartis and grants and personal fees from Mylan, outside the submitted work. Dr Bernal‐Sprekelsen has nothing to disclose. Dr Bjermer is member of the Board of EUFOREA that owns the mySinusitisCoach application. Dr Callebaut has nothing to disclose. Dr Cardell reports grants from Sanofi, outside the submitted work. Dr Carrie has nothing to disclose. Dr Castelnuovo has nothing to disclose. Dr Cathcart has nothing to disclose. Dr Clement has nothing to disclose. Dr Constantinidis has nothing to disclose. Ms Cools has nothing to disclose. Dr Cornet has nothing to disclose. Dr Cox has nothing to disclose. Dr Correia‐de‐Sousa reports other from Boheringer Ingelheim, grants, personal fees and other from GSK, grants and other from AstraZeneca, personal fees from Mundipharma, outside the submitted work. Dr De Bont has nothing to disclose. Ms Deneyer is employed by Change Accelerator in Respiratory Diseases. Dr Delsupehe has nothing to disclose. Dr Devos has nothing to disclose. Dr Doulaptsi has nothing to disclose. Dr Fokkens reports that the Amsterdam University Medical Centres, location AMC receives grants and Stichting AERO receives personal fees from Sanofi and Novartis, grants from Gsk, from Meda, from ALK, from Allergy therapeutics, outside the submitted work. Dr Gane has nothing to disclose. Dr Gevaert has nothing to disclose. Dr Hellings reports personal fees from Sanofi, personal fees from Allergopharma, personal fees from Stallergenes, grants and personal fees from Mylan, outside the submitted work. He is also member of the Board of EUFOREA that owns the mySinusitisCoach application. Dr Hopkins has nothing to disclose. Dr Hox reports personal fees from Consultant work for ALK, outside the submitted work. Dr Hummel reports grants from Sony, Stuttgart, Germany, grants from Smell and Taste Lab, Geneva, Switzerland, grants from Takasago, Paris, France, grants from aspuraclip, Berlin, Germany, outside the submitted work. Dr Hosemann has nothing to disclose. Dr Jacobs has nothing to disclose. Dr Jorissen has nothing to disclose. Dr Kjeldsen reports other from Astra Zeneca, outside the submitted work. Dr Landis has nothing to disclose. Dr Lemmens has nothing to disclose. Dr Leunig has nothing to disclose. Dr Lund has nothing to disclose. Mr Mariën is employed by Change Accelerator in Respiratory Diseases and advisor to EUFOREA. Dr Mullol reports personal fees and other from SANOFI‐GENZYME & REGENERON, NOVARTIS and ALLAKOS, grants and personal fees from MYLAN Pharma and URIACH Group, personal fees from Mitsubishi‐Tanabe, Menarini, UCB, AstraZeneca, GSK and MSD, outside the submitted work. Dr Onerci has nothing to disclose. Mrs Palkonen has nothing to disclose. Mrs Proano has nothing to disclose. Dr Prokopakis has nothing to disclose. Dr Pugin has nothing to disclose. Dr Ryan reports personal fees and non‐financial support from Mylan, personal fees from Chiesi, personal fees from GSK, personal fees from Novartis, personal fees from Regeneron, personal fees from BI, outside the submitted work. Dr Riechelmann has nothing to disclose. Dr Sahlstrand Johnson reports grants and personal fees from Medtronic, outside the submitted work. Dr Toppila‐Salmi reports personal fees from ERT, Roche products, Sanofi Pharma and Novartis, grants from GSK, outside the submitted work. Dr Segboer has nothing to disclose. Dr Seys is employed by Change Accelerator in Respiratory Diseases. Dr Speleman has nothing to disclose. Dr Steinsvik has nothing to disclose. Dr Surda has nothing to disclose. Dr Tomazic has nothing to disclose. Dr Vanderveken has nothing to disclose. Dr Van Gerven has nothing to disclose. Dr Van Zele has nothing to disclose. Dr Verfaillie has nothing to disclose. Dr Verhaeghe has nothing to disclose. Dr Vierstraete has nothing to disclose. Dr Vlaminck has nothing to disclose. Dr Wagenmann reports personal fees from ALK‐Abelló, Allergopharma, AstraZeneca, Bencard Allergie, Genzyme, HAL Allergie, Infectopharm, LETI Pharma, MEDA Pharma, Novartis, Sanofi Aventis, Stallergenes and Teva, outside the submitted work.

Figures

Figure 1
Figure 1
Evaluation of disease control and impact of sinusitis symptoms on sleep quality and daily life activities. A. The level of disease control was defined by VAS global sinusitis symptom score: controlled (VAS ≤ 20 mm), partly controlled (VAS > 20 mm and ≤ 50 mm) and uncontrolled (VAS > 50 mm and ≤ 100 mm). B. Disease control was assessed by evaluation of 5 characteristics (nasal blockage, rhinorrhoea/postnasal drip, facial pain or pressure, impaired sense of smell and sleep disturbance or fatigue) that are deemed critical to determine the level of disease control according to EPOS guidelines: controlled (no symptoms present), partly controlled (presence of one symptom) or uncontrolled (presence of 3 or more symptoms). A VAS level higher than 50 mm defined the presence of one of the respective symptoms. C. The impact of the patients’ rhinosinusitis symptoms on sleep quality and daily life activities were evaluated by VAS: “How much are your sinusitis symptoms affecting your sleep quality?” and “How much are your sinusitis symptoms affecting your work and daily activities today?” Data are presented as median with interquartile range. Three groups of CRS patients stratified by disease control were compared by use of Kruskal‐Wallis test and Dunn's multiple comparison test (as post hoc test). ****: P < .0001 compared to controlled, #: P < .0001 compared to partly controlled
Figure 2
Figure 2
Comparison of global and specific rhinosinusitis symptoms between CRSsNP and CRSwNP phenotypes. Global rhinosinusitis symptoms were assessed by VAS: “How much are your global sinusitis symptoms bothering you today?”. Major symptom was defined as the most bothersome (highest VAS score) specific CRS symptom. Data are presented as median with interquartile range (missing information on NP status in 82 patients). Mann‐Whitney U test was used for in‐between group comparison. **: P < .01, ****: P < .0001
Figure 3
Figure 3
Analysis of the major symptom between CRSsNP and CRSwNP phenotypes. The proportion of patients with a particular major symptom was compared between CRSsNP and CRSwNP. Major symptom was defined as the most bothersome (highest VAS score) specific CRS symptom. Missing information on NP status in 82 patients
Figure 4
Figure 4
Prevalence of self‐reported asthma (A) and burden of bronchial symptoms (B) in mSC users. A. Information on self‐reported asthma was extracted from the health profile of mSC users. B. Bronchial symptoms were assessed by VAS: “How much is shortness of breath or wheezing bothering you today?”. Data are presented as median with interquartile range. Three groups of CRS patients stratified by disease control were compared by use of Kruskal‐Wallis test and Dunn's multiple comparison test (as post hoc test). *: P < .05 compared to controlled, ****: P < .0001 compared to controlled, #: P < .01 compared to partly controlled
Figure 5
Figure 5
Evaluation of global and specific rhinosinusitis symptoms in CRS patients stratified by the number of functional endoscopic sinus surgery (FESS) procedures. Information on the number of FESS procedures was extracted from the health profile of mSC users. Five groups of CRS patients stratified by the number of FESS procedures were compared by use of Kruskal‐Wallis test and Dunn's multiple comparison test (as post hoc test). **: P < .01 compared to 0 FESS procedures
See this image and copyright information in PMC

References

    1. Fokkens WJ, Lund VJ, Mullol J, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl. 2012;23:1‐298. - PubMed
    1. Bachert C, Pawankar R, Zhang L, et al. ICON: chronic rhinosinusitis. World Allergy Organ J. 2014;7(1):25. - PMC - PubMed
    1. Hastan D, Fokkens WJ, Bachert C, et al. Chronic rhinosinusitis in Europe–an underestimated disease. A GA2LEN study. Allergy. 2011;66(9):1216‐1223. - PubMed
    1. Hirsch AG, Stewart WF, Sundaresan AS, et al. Nasal and sinus symptoms and chronic rhinosinusitis in a population‐based sample. Allergy. 2017;72(2):274‐281. - PMC - PubMed
    1. De Greve G, Hellings PW, Fokkens WJ, Pugin B, Steelant B, Seys SF. Endotype‐driven treatment in chronic upper airway diseases. Clin Transl Allergy. 2017;7:22. - PMC - PubMed