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Guideline Adherence to Benign Paroxysmal Positional Vertigo Treatment and Management in Primary Care.

Publication ,  Journal Article
Del Risco, A; Cherches, A; Smith, SL; Riska, KM
Published in: Otolaryngol Head Neck Surg
October 2023

OBJECTIVE: To determine adherence to the 2017 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines for the management and treatment of benign paroxysmal positional vertigo (BPPV) in primary care (PC) and compare whether key recommendations differed by sex, race, or insurance status. STUDY DESIGN: Retrospective chart review. SETTING: Twenty-six clinic locations within a single healthcare system. METHODS: Charts of 458 patients diagnosed with BPPV in PC between 2018 and 2022 were reviewed. Encounters where the diagnosis of BPPV was made were identified. From the clinical encounter note, demographics, symptomatology, management, and treatment were extracted. Nonparametric analyses were used to identify whether AAO-HNS guidelines differed regarding sex, race, or insurance status. RESULTS: Of 458 patients, 249 (54.4%) did not receive a diagnostic exam, and only 4 (0.9%) patients received imaging. Regarding treatment, only 51 (11.1%) received the Epley maneuver, with 263 (57.4%) receiving vestibular suppressant medication and 12.4% receiving a referral to a specialist. In regard to sex, race, or insurance status, there was no significant difference in receiving a Dix-Hallpike diagnostic maneuver, Epley maneuver, vestibular suppressant medication, imaging, or referral to a specialist. CONCLUSION: Our data suggest that there continue to be gaps in the adherence to AAO-HNS guidelines; however, these gaps did not differ by sex, race, or insurance status. Care should be taken to increase the use of diagnostic and treatment maneuvers but decrease the use of vestibular-suppressant medications for the treatment of BPPV in PC.

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Published In

Otolaryngol Head Neck Surg

DOI

EISSN

1097-6817

Publication Date

October 2023

Volume

169

Issue

4

Start / End Page

865 / 874

Location

England

Related Subject Headings

  • Vestibule, Labyrinth
  • Retrospective Studies
  • Primary Health Care
  • Otorhinolaryngology
  • Humans
  • Guideline Adherence
  • Benign Paroxysmal Positional Vertigo
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
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Del Risco, A., Cherches, A., Smith, S. L., & Riska, K. M. (2023). Guideline Adherence to Benign Paroxysmal Positional Vertigo Treatment and Management in Primary Care. Otolaryngol Head Neck Surg, 169(4), 865–874. https://doi.org/10.1002/ohn.315
Del Risco, Amanda, Alex Cherches, Sherri L. Smith, and Kristal M. Riska. “Guideline Adherence to Benign Paroxysmal Positional Vertigo Treatment and Management in Primary Care.Otolaryngol Head Neck Surg 169, no. 4 (October 2023): 865–74. https://doi.org/10.1002/ohn.315.
Del Risco A, Cherches A, Smith SL, Riska KM. Guideline Adherence to Benign Paroxysmal Positional Vertigo Treatment and Management in Primary Care. Otolaryngol Head Neck Surg. 2023 Oct;169(4):865–74.
Del Risco, Amanda, et al. “Guideline Adherence to Benign Paroxysmal Positional Vertigo Treatment and Management in Primary Care.Otolaryngol Head Neck Surg, vol. 169, no. 4, Oct. 2023, pp. 865–74. Pubmed, doi:10.1002/ohn.315.
Del Risco A, Cherches A, Smith SL, Riska KM. Guideline Adherence to Benign Paroxysmal Positional Vertigo Treatment and Management in Primary Care. Otolaryngol Head Neck Surg. 2023 Oct;169(4):865–874.
Journal cover image

Published In

Otolaryngol Head Neck Surg

DOI

EISSN

1097-6817

Publication Date

October 2023

Volume

169

Issue

4

Start / End Page

865 / 874

Location

England

Related Subject Headings

  • Vestibule, Labyrinth
  • Retrospective Studies
  • Primary Health Care
  • Otorhinolaryngology
  • Humans
  • Guideline Adherence
  • Benign Paroxysmal Positional Vertigo
  • 3202 Clinical sciences
  • 1103 Clinical Sciences