TY - JOUR
T1 - Patient perceptions of effectiveness in treatments for menière's disease
T2 - A national survey in italy
AU - Ward, Bryan
AU - Wettstein, Vincent
AU - Golding, John
AU - Corallo, Giulia
AU - Nuti, Daniele
AU - Trabalzini, Franco
AU - Mandalà, Marco
N1 - Publisher Copyright:
© 2019 by The European Academy of Otology and Neurotology and The Politzer Society.
PY - 2019
Y1 - 2019
N2 - OBJECTIVES: The aim of the present study was to investigate current treatment practices and self-reported effectiveness in Ménière’s disease. MATERIALS and METHODS: Members of two Italian Ménière’s disease support (n=170) with ≥6-month history of Ménière’s disease were administered an online survey about recent treatments. Vertigo episode count, work absenteeism, and limitations in family life, social life, work, or travel as included in the Social Life and Work Impact of Dizziness Questionnaire before and after recent treatments were queried. RESULTS: Twenty-four different treatments were reported for Ménière’s disease, with dietary modifications (55%), diuretics (47%), and betahistine (41%) being the most common. The majority (71%) received multiple simultaneous treatments. Prior to the most recent treatments, 78%-89% of respondents indicated limitations in family or social life, work, or traveling. After their most recent treatment, respondents reported improvements in mean vertigo episode counts (5.7±7.6 vs. 2.6±4.6, p<0.001), days off work per month (10.1±9.2 vs. 4.2±6.7, p<0.001), and proportions indicating limitations in any functional measure assessed (p<0.05). These findings were consistent regardless of treatment approach (p<0.05 for all). Intratympanic gentamicin provided the greatest reductions in vertigo count, functional limitations, and work absenteeism (p<0.01 for all), as well as the fewest respondents reporting post-treatment functional limitations (16%-37%). CONCLUSION: Despite many treatment approaches targeting different proposed pathophysiology for Ménière’s disease in this cross-sectional survey, all treatments are reported as effective by patients. These findings support a prominent placebo effect in Ménière’s disease and highlight challenges in studying treatment outcomes; there is a critical need to better understand Ménière’s disease.
AB - OBJECTIVES: The aim of the present study was to investigate current treatment practices and self-reported effectiveness in Ménière’s disease. MATERIALS and METHODS: Members of two Italian Ménière’s disease support (n=170) with ≥6-month history of Ménière’s disease were administered an online survey about recent treatments. Vertigo episode count, work absenteeism, and limitations in family life, social life, work, or travel as included in the Social Life and Work Impact of Dizziness Questionnaire before and after recent treatments were queried. RESULTS: Twenty-four different treatments were reported for Ménière’s disease, with dietary modifications (55%), diuretics (47%), and betahistine (41%) being the most common. The majority (71%) received multiple simultaneous treatments. Prior to the most recent treatments, 78%-89% of respondents indicated limitations in family or social life, work, or traveling. After their most recent treatment, respondents reported improvements in mean vertigo episode counts (5.7±7.6 vs. 2.6±4.6, p<0.001), days off work per month (10.1±9.2 vs. 4.2±6.7, p<0.001), and proportions indicating limitations in any functional measure assessed (p<0.05). These findings were consistent regardless of treatment approach (p<0.05 for all). Intratympanic gentamicin provided the greatest reductions in vertigo count, functional limitations, and work absenteeism (p<0.01 for all), as well as the fewest respondents reporting post-treatment functional limitations (16%-37%). CONCLUSION: Despite many treatment approaches targeting different proposed pathophysiology for Ménière’s disease in this cross-sectional survey, all treatments are reported as effective by patients. These findings support a prominent placebo effect in Ménière’s disease and highlight challenges in studying treatment outcomes; there is a critical need to better understand Ménière’s disease.
KW - Dizziness
KW - Sensorineural hearing loss
KW - Social impact
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U2 - 10.5152/iao.2019.5758
DO - 10.5152/iao.2019.5758
M3 - Article
C2 - 31058600
AN - SCOPUS:85065662483
SN - 1308-7649
VL - 15
SP - 112
EP - 117
JO - Journal of International Advanced Otology
JF - Journal of International Advanced Otology
IS - 1
ER -