Patient perceptions of effectiveness in treatments for menière's disease

A national survey in italy

Bryan Ward, Vincent Wettstein, John Golding, Giulia Corallo, Daniele Nuti, Franco Trabalzini, Marco Mandalà

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)112-117
Number of pages6
JournalJournal of International Advanced Otology
Volume15
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Italy
Vertigo
Therapeutics
Absenteeism
Surveys and Questionnaires
Betahistine
Diet Therapy
Placebo Effect
Dizziness
Gentamicins
Diuretics
Cross-Sectional Studies

Keywords

  • Dizziness
  • Sensorineural hearing loss
  • Social impact

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Patient perceptions of effectiveness in treatments for menière's disease : A national survey in italy. / Ward, Bryan; Wettstein, Vincent; Golding, John; Corallo, Giulia; Nuti, Daniele; Trabalzini, Franco; Mandalà, Marco.

In: Journal of International Advanced Otology, Vol. 15, No. 1, 01.01.2019, p. 112-117.

Research output: Contribution to journalArticle

Ward, Bryan ; Wettstein, Vincent ; Golding, John ; Corallo, Giulia ; Nuti, Daniele ; Trabalzini, Franco ; Mandalà, Marco. / Patient perceptions of effectiveness in treatments for menière's disease : A national survey in italy. In: Journal of International Advanced Otology. 2019 ; Vol. 15, No. 1. pp. 112-117.
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abstract = "OBJECTIVES: The aim of the present study was to investigate current treatment practices and self-reported effectiveness in M{\'e}ni{\`e}re’s disease. MATERIALS and METHODS: Members of two Italian M{\'e}ni{\`e}re’s disease support (n=170) with ≥6-month history of M{\'e}ni{\`e}re’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 M{\'e}ni{\`e}re’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 M{\'e}ni{\`e}re’s disease in this cross-sectional survey, all treatments are reported as effective by patients. These findings support a prominent placebo effect in M{\'e}ni{\`e}re’s disease and highlight challenges in studying treatment outcomes; there is a critical need to better understand M{\'e}ni{\`e}re’s disease.",
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