Identifying barriers to care for complex airway disease and multidisciplinary solutions to optimize therapy in Canada
Abstract Background Complex airway disease such as Chronic Rhinosinusitis with Asthma or Aspirin Exacerbated Respiratory Disease requires a multidisciplinary approach to management and treatment. Many centers in the USA have created collaborative multidisciplinary clinics to support the management o...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2022-04-01
|
| Series: | Journal of Otolaryngology - Head and Neck Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40463-022-00576-8 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850283165847912448 |
|---|---|
| author | A. Cherukupalli M. Yong Y. Chan M. Desrosiers A. Thamboo |
| author_facet | A. Cherukupalli M. Yong Y. Chan M. Desrosiers A. Thamboo |
| author_sort | A. Cherukupalli |
| collection | DOAJ |
| description | Abstract Background Complex airway disease such as Chronic Rhinosinusitis with Asthma or Aspirin Exacerbated Respiratory Disease requires a multidisciplinary approach to management and treatment. Many centers in the USA have created collaborative multidisciplinary clinics to support the management of these patients; however, similar structures do not appear to exist in Canada. Methods This mixed methods study used a combination of structured interviews and a cross-sectional national survey. Interviewees included members of the Canadian Rhinology Working Group and survey participants were a combination of academic and community Rhinologists, Respirologists and Allergists. All participation was voluntary and selection criteria was based on their involvement in treating complex airway disease. Our objective was to identify the current state of diagnosis and treatment of complex airway patients in Canada between Rhinology, Respirology and Allergy and understand the barriers, challenges and propose solutions to establishing a multidisciplinary airway clinic in Canada. Results Four Rhinologists participated in qualitative interviews and a convenience sample of 42 specialists through our known network responded to our quantitative survey. From our survey, 54.8% believed multidisciplinary clinics were necessary in the management of complex airway disease, providing better outcomes and cost-savings (69%, 45.2%). Most specialties agreed that history, physical, pulmonary function and skin prick testing was important for diagnosis (92.9%, 92.9%, 88.1%). If clinicians were to participate in a multidisciplinary clinic, they would be willing to forego an average of 14.2% of their mean daily income for that clinic. The ideal clinic location was split between a neutral shared location vs. a Rhinology clinic space (38.1%, 45.2%). Conclusions Complex airway diseases are currently managed in subspecialty silos resulting in fragmented care. Our study highlights gaps in management, areas for improvement and support for establishing multidisciplinary complex airway disease clinics in Canada to better treat this population. |
| format | Article |
| id | doaj-art-feebbc8a4b4f49ebba567d17a5a72eb7 |
| institution | OA Journals |
| issn | 1916-0216 |
| language | English |
| publishDate | 2022-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Otolaryngology - Head and Neck Surgery |
| spelling | doaj-art-feebbc8a4b4f49ebba567d17a5a72eb72025-08-20T01:47:50ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162022-04-0151111010.1186/s40463-022-00576-8Identifying barriers to care for complex airway disease and multidisciplinary solutions to optimize therapy in CanadaA. Cherukupalli0M. Yong1Y. Chan2M. Desrosiers3A. Thamboo4Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, Diamond Healthcare Center, University of British ColumbiaDivision of Otolaryngology-Head & Neck Surgery, Department of Surgery, Diamond Healthcare Center, University of British ColumbiaDepartment of Otolaryngology-Head & Neck Surgery, Department of Surgery, University of TorontoDivision of Otolaryngology-Head & Neck Surgery, Department of Surgery, McGill UniversityDivision of Otolaryngology-Head & Neck Surgery, Department of Surgery, Diamond Healthcare Center, University of British ColumbiaAbstract Background Complex airway disease such as Chronic Rhinosinusitis with Asthma or Aspirin Exacerbated Respiratory Disease requires a multidisciplinary approach to management and treatment. Many centers in the USA have created collaborative multidisciplinary clinics to support the management of these patients; however, similar structures do not appear to exist in Canada. Methods This mixed methods study used a combination of structured interviews and a cross-sectional national survey. Interviewees included members of the Canadian Rhinology Working Group and survey participants were a combination of academic and community Rhinologists, Respirologists and Allergists. All participation was voluntary and selection criteria was based on their involvement in treating complex airway disease. Our objective was to identify the current state of diagnosis and treatment of complex airway patients in Canada between Rhinology, Respirology and Allergy and understand the barriers, challenges and propose solutions to establishing a multidisciplinary airway clinic in Canada. Results Four Rhinologists participated in qualitative interviews and a convenience sample of 42 specialists through our known network responded to our quantitative survey. From our survey, 54.8% believed multidisciplinary clinics were necessary in the management of complex airway disease, providing better outcomes and cost-savings (69%, 45.2%). Most specialties agreed that history, physical, pulmonary function and skin prick testing was important for diagnosis (92.9%, 92.9%, 88.1%). If clinicians were to participate in a multidisciplinary clinic, they would be willing to forego an average of 14.2% of their mean daily income for that clinic. The ideal clinic location was split between a neutral shared location vs. a Rhinology clinic space (38.1%, 45.2%). Conclusions Complex airway diseases are currently managed in subspecialty silos resulting in fragmented care. Our study highlights gaps in management, areas for improvement and support for establishing multidisciplinary complex airway disease clinics in Canada to better treat this population.https://doi.org/10.1186/s40463-022-00576-8MultidisciplinaryComplex airway diseaseAERDChronic RhinosinusitisCross-disciplinaryAllergy |
| spellingShingle | A. Cherukupalli M. Yong Y. Chan M. Desrosiers A. Thamboo Identifying barriers to care for complex airway disease and multidisciplinary solutions to optimize therapy in Canada Journal of Otolaryngology - Head and Neck Surgery Multidisciplinary Complex airway disease AERD Chronic Rhinosinusitis Cross-disciplinary Allergy |
| title | Identifying barriers to care for complex airway disease and multidisciplinary solutions to optimize therapy in Canada |
| title_full | Identifying barriers to care for complex airway disease and multidisciplinary solutions to optimize therapy in Canada |
| title_fullStr | Identifying barriers to care for complex airway disease and multidisciplinary solutions to optimize therapy in Canada |
| title_full_unstemmed | Identifying barriers to care for complex airway disease and multidisciplinary solutions to optimize therapy in Canada |
| title_short | Identifying barriers to care for complex airway disease and multidisciplinary solutions to optimize therapy in Canada |
| title_sort | identifying barriers to care for complex airway disease and multidisciplinary solutions to optimize therapy in canada |
| topic | Multidisciplinary Complex airway disease AERD Chronic Rhinosinusitis Cross-disciplinary Allergy |
| url | https://doi.org/10.1186/s40463-022-00576-8 |
| work_keys_str_mv | AT acherukupalli identifyingbarrierstocareforcomplexairwaydiseaseandmultidisciplinarysolutionstooptimizetherapyincanada AT myong identifyingbarrierstocareforcomplexairwaydiseaseandmultidisciplinarysolutionstooptimizetherapyincanada AT ychan identifyingbarrierstocareforcomplexairwaydiseaseandmultidisciplinarysolutionstooptimizetherapyincanada AT mdesrosiers identifyingbarrierstocareforcomplexairwaydiseaseandmultidisciplinarysolutionstooptimizetherapyincanada AT athamboo identifyingbarrierstocareforcomplexairwaydiseaseandmultidisciplinarysolutionstooptimizetherapyincanada |