adherence in global airways

Conditions: Chronic Rhinosinusitis Without Nasal Polyps; Asthma; Chronic Rhinosinusitis With Nasal Polyps; Chronic Rhinosinusitis (Diagnosis)

Summary: there is a strong case for treating diseases of both the upper and lower airways (global airways) simultaneously because they share the same inflammatory mechanisms. about 9% have chronic sinusitis (crs) and 4% of the danish population are diagnosed with crs with nasal polyps (crswnp)) and 7-10% have asthma. crs has a multifactorial background, with crswnp characterized by type 2 inflammation, and approximately 50% with type 2 crswnp also have co-morbid asthma. well-treated crs has an impact on asthma control, and well-treated asthma has an impact on crs. several studies show that patients with asthma have low adherence, but only a few if any of studies are available on adherence in crs. aim: to investigate the effect of systematic and structured nursing supervision in patients with crswnp and asthma primarily on adherence. hypothesis and research questions: patients with respiratory diseases can improve their adherence to their non-medical and medical treatment for crswnp/crs and asthma by systematic and structured nursing supervision compared to patients who receive usual care. in a randomized clinical trial, we will investigate whether the level of adherence measured by the questionnaire mars-5-n and mars-5- l in patients with crswnp and asthma can be improved by 7 points after systematic and structured nursing guidance at baseline visit and controlled after four months - compared with those patients who have not received the above guidance. primary outcome: is change in adherence rate measured by the mars-5-n/l questionnaire in patients with crswnp and asthma can be improved by 4 points after systematic and structured nursing guidance at the initial visit and controlled after four months - compared with patients who have not received the above guidance. inclusion criteria: adherence to mars- 5 l/n ≤35 at first visit, diagnosed with asthma (with/without allergic rhinitis) at initial visit, diagnosed with crswnp, able to use smartphone, acq ≥1.2 or act≤15 (partially uncontrolled asthma), \>18 years of age, snot-22 score ≥35 exclusion criteria: * adherence to mars-5- l/n \>35 points at first visit,do not have smartphone, does not read/speak english, other illness requiring regular medication, pregnancy/pregnancy that started during the study, server psychological comorbidities questionnaires: patients must answer the following questionnaires at baseline and at 4 months follow up ess, snot-22, acq-7, act, miniaqlq, hads, starr-15


Eligibility criteria:
inclusion criteria: * adherence to mars- 5 l/n ≤35 at first visit * diagnosed with asthma (with and without allergic rhinitis) at initial visit * able to use smartphone * acq ≥1.2 or act≤15 (partially uncontrolled asthma) * be over 18 years of age * snot-22 score ≥35 * diagnosed with crswnp exclusion criteria: * adherence to mars-5- l/n \>35 points at first visit * do not have smartphone * does not read or speak english * other illness requiring regular medication * pregnancy and pregnancy that started during the study time period * servere psychological comorbidities

Keywords: adherence nurse global airways astma chronic rhinosinusitis with nasal polyps