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Optimization of Rhinosinusitis Care in a Resource-Limited Setting
Kruglik, Christopher Peter Dorwart, Michelle
Kruglik, Christopher Peter
Dorwart, Michelle
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This study evaluated strategies to optimize rhinosinusitis management in a resource-limited federally qualified health center in Burlington, Vermont. Key challenges identified included the discontinuation of Medicaid coverage for over-the-counter (OTC) medications critical to rhinosinusitis treatment and limited access to otolaryngology specialists, necessitating enhanced primary care provider (PCP) competency in outpatient management and patient navigation of socioeconomic barriers. Semi-structured interviews were conducted with a clinical pharmacist and a community member to assess care barriers and patient perspectives. Interventions comprised (1) an evidence-based clinical decision-support flowchart for PCPs to guide acute and chronic rhinosinusitis management, and (2) a comparative cost analysis tool for OTC therapies. While Costco offered the lowest medication prices, its membership requirement posed an accessibility barrier for low-income patients. The study underscores the need for interdisciplinary collaboration between primary care and community pharmacies to mitigate cost-related disparities. Future efforts should prioritize partnerships with local pharmacies to subsidize OTC access and advocate for policy reforms to reinstate Medicaid coverage for essential therapies.
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2024-01-01
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Kruglik_FMProject.pdf
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