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EPOS Primary Care Guidelines: European Position Paper on the Primary Care Diagnosis and Management of Rhinosinusitis and Nasal Polyps 2007 - a summary.

Abstract

This paper is a summary of the 2007 European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS)1 which was published in Rhinology in 2007. In order to widen dissemination of the EP3OS paper, the editors of Rhinology and the Primary Care Respiratory Journal (PCRJ) have agreed to publish this summary - which is focussed on the needs of general practitioners and community-based non-specialist clinicians - in the PCRJ. In the EP3OS process, an evidence-based methodology was used to identify evidence and to grade recommendations for clinical practice for the management of rhinosinusitis. The EP3OS Taskforce was commissioned by the European Academy of Allergology and Clinical Immunology (EAACI) with the aims of: * Presenting specialist and generalist clinicians with an updated summary of knowledge of rhinosinusitis and nasal polyposis * Providing clinicans with an evidence-based summary of diagnostic methods appropriate for specialist and generalist settings * Providing evidence-based recommendations for management in specialist and generalist settings * Proposing guidance for definitions and outcome measurements in clinical practice and in research in different settings. The current document aims to distil the information presented in the full EP3OS document1 into a shorter and more concise format suitable for use in primary care generalist settings. The summary recommendations for generalists are that clinicians should be aware that rhinitis and sinusitis usually co-exist, and that management strategies should encompass this. Acute rhinosinusitis is an inflammatory condition that may be diagnosed on the basis of acute symptoms of nasal blockage, obstruction, congestion with or without facial pain or reduced smell; many episodes are self-limiting, but where symptoms persist or increase after five days, topical nasal steroids may be considered, with addition of antibiotics in patients with more severe or increasing symptoms. Non-resolution in 14 days, or the presence of atypical symptoms, should prompt consideration of referral to specialist care. Chronic rhinosinusitis occurs when symptoms have been present for >12 weeks, and anterior rhinoscopy or more detailed endoscopy should be performed to identify polyps. Topical nasal corticosteroids, nasal douching, and use of antihistamines in allergic patients, may be used in patients without, or with less symptomatic, polyps; referral to specialist care is needed for patients whose symptoms do not respond or who have large polyps.

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  • Authors+Show Affiliations

    ,

    Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, Scotland, UK. mikethomas@doctors.org.uk

    , , , , ,

    Source

    MeSH

    Europe
    Humans
    Nasal Polyps
    Practice Guidelines as Topic
    Primary Health Care
    Rhinitis
    Sinusitis

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    18438594

    Citation

    Thomas, Mike, et al. "EPOS Primary Care Guidelines: European Position Paper On the Primary Care Diagnosis and Management of Rhinosinusitis and Nasal Polyps 2007 - a Summary." Primary Care Respiratory Journal : Journal of the General Practice Airways Group, vol. 17, no. 2, 2008, pp. 79-89.
    Thomas M, Yawn BP, Price D, et al. EPOS Primary Care Guidelines: European Position Paper on the Primary Care Diagnosis and Management of Rhinosinusitis and Nasal Polyps 2007 - a summary. Prim Care Respir J. 2008;17(2):79-89.
    Thomas, M., Yawn, B. P., Price, D., Lund, V., Mullol, J., & Fokkens, W. (2008). EPOS Primary Care Guidelines: European Position Paper on the Primary Care Diagnosis and Management of Rhinosinusitis and Nasal Polyps 2007 - a summary. Primary Care Respiratory Journal : Journal of the General Practice Airways Group, 17(2), pp. 79-89. doi:10.3132/pcrj.2008.00029.
    Thomas M, et al. EPOS Primary Care Guidelines: European Position Paper On the Primary Care Diagnosis and Management of Rhinosinusitis and Nasal Polyps 2007 - a Summary. Prim Care Respir J. 2008;17(2):79-89. PubMed PMID: 18438594.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - EPOS Primary Care Guidelines: European Position Paper on the Primary Care Diagnosis and Management of Rhinosinusitis and Nasal Polyps 2007 - a summary. AU - Thomas,Mike, AU - Yawn,Barbara P, AU - Price,David, AU - Lund,Valerie, AU - Mullol,Jocquim, AU - Fokkens,Wytske, AU - ,, PY - 2008/4/29/pubmed PY - 2008/9/26/medline PY - 2008/4/29/entrez SP - 79 EP - 89 JF - Primary care respiratory journal : journal of the General Practice Airways Group JO - Prim Care Respir J VL - 17 IS - 2 N2 - This paper is a summary of the 2007 European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS)1 which was published in Rhinology in 2007. In order to widen dissemination of the EP3OS paper, the editors of Rhinology and the Primary Care Respiratory Journal (PCRJ) have agreed to publish this summary - which is focussed on the needs of general practitioners and community-based non-specialist clinicians - in the PCRJ. In the EP3OS process, an evidence-based methodology was used to identify evidence and to grade recommendations for clinical practice for the management of rhinosinusitis. The EP3OS Taskforce was commissioned by the European Academy of Allergology and Clinical Immunology (EAACI) with the aims of: * Presenting specialist and generalist clinicians with an updated summary of knowledge of rhinosinusitis and nasal polyposis * Providing clinicans with an evidence-based summary of diagnostic methods appropriate for specialist and generalist settings * Providing evidence-based recommendations for management in specialist and generalist settings * Proposing guidance for definitions and outcome measurements in clinical practice and in research in different settings. The current document aims to distil the information presented in the full EP3OS document1 into a shorter and more concise format suitable for use in primary care generalist settings. The summary recommendations for generalists are that clinicians should be aware that rhinitis and sinusitis usually co-exist, and that management strategies should encompass this. Acute rhinosinusitis is an inflammatory condition that may be diagnosed on the basis of acute symptoms of nasal blockage, obstruction, congestion with or without facial pain or reduced smell; many episodes are self-limiting, but where symptoms persist or increase after five days, topical nasal steroids may be considered, with addition of antibiotics in patients with more severe or increasing symptoms. Non-resolution in 14 days, or the presence of atypical symptoms, should prompt consideration of referral to specialist care. Chronic rhinosinusitis occurs when symptoms have been present for >12 weeks, and anterior rhinoscopy or more detailed endoscopy should be performed to identify polyps. Topical nasal corticosteroids, nasal douching, and use of antihistamines in allergic patients, may be used in patients without, or with less symptomatic, polyps; referral to specialist care is needed for patients whose symptoms do not respond or who have large polyps. SN - 1471-4418 UR - https://www.unboundmedicine.com/medline/citation/18438594/EPOS_Primary_Care_Guidelines:_European_Position_Paper_on_the_Primary_Care_Diagnosis_and_Management_of_Rhinosinusitis_and_Nasal_Polyps_2007___a_summary_ L2 - https://dx.doi.org/10.3132/pcrj.2008.00029 DB - PRIME DP - Unbound Medicine ER -