Nasal Polyp Symptoms: How Well Do Physicians Know Their Patients?

In severe cases, nasal polyps (NPs) can be debilitating. It is poorly understood to what extent the frequency and severity of symptoms experienced by patients are recognized by their physician. Patients diagnosed with moderate-severe NPs who consulted with a specialist physician in the US (2018-2019) were surveyed using the Adelphi NPs Disease Specific Programme (DSPTM). Using SNOT-22 completed by patients, a post-hoc analysis compared the percent agreement of physician’s assessments of the same 22 symptoms. 351 patients and their physicians were surveyed; 112 pairs completed ≥1 question on the SNOTT-22. Ear fullness, thick nasal discharge, sneezing, reduced concentration, reduced productivity, waking up tired, and feeling frustrated/restless/irritable were reported by >50% of patients-only: The highest severity discrepancy was thick nasal discharge: reported as “severe” or symptoms “as bad as it can be” by 20.7% of patients and 1.1% of physicians (n=87). The most commonly reported NP symptoms rated as at least severe by both the patient and physician were nasal blockage (47.7 vs 19.3%, n=109), post-nasal discharge (26.0 vs 6.0%, n=100), decreased sense of smell/taste (42.5 vs 13.1%, n=99), runny nose (26.1 vs 5.7%, n=88) and need to blow nose (13.8 vs 2.3%, n=87). While there is a high level of agreement in physician and patient recognition of typical NP symptoms such as nasal blockage, severity is commonly underestimated by physicians. In addition, there are many atypical symptoms that go unnoticed by the physician highlighting the hidden burden existing therapies may not currently address.