{"title":"Evaluating Treatment Patterns in Bell's Palsy Using Nationwide Employer-Sponsored Healthcare Claims.","authors":"Sujay Ratna, Shaun Edalati, Yehia Elkersh, Parul Agarwal, Joshua Rosenberg, Mingyang Gray","doi":"10.1002/lary.32115","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Professional society guidelines provide clear recommendations regarding the use of high-dose steroids and/or antiviral therapy for Bell's palsy patients. This study evaluates national trends in the care of Bell's palsy patients and identifies current treatments.</p><p><strong>Methods: </strong>A retrospective cohort study of adult Bell's palsy patients was conducted using ICD-9-CM and ICD-10-CM diagnosis codes from 2013 to 2020. These patients were continuously enrolled in the employer-sponsored MarketScan commercial or Medicare outpatient and prescription drug claims data for at least 1 year. The main outcome of interest was prescription rates of high-dose steroids and antivirals after the diagnosis date.</p><p><strong>Results: </strong>In this cohort of 66,708 adult Bell's palsy patients, 29,824 (44.7%) received no treatment. 22,736 (34.1%) received combination therapy, 11,866 (17.8%) received steroids only, and 2282 (3.4%) received antivirals only. Males were more likely to receive combination therapy. 51.9% of Bell's palsy patients in this cohort received the AAO-recommended treatment of steroids within 72 h of diagnosis. Patients in the Southern and Western United States were more commonly prescribed combination therapy. Comorbidities such as cerebrovascular disease and symptoms like ear pain were associated with a higher likelihood of receiving combination therapy. Treatment initiation, particularly for steroids, occurred on the index date, first insurance claim, in 94.56% of cases.</p><p><strong>Conclusion: </strong>Only 51.9% of Bell's palsy patients in this cohort received the AAO-recommended treatment with high-dose steroids with or without antiviral therapy. This research provides valuable insights into the real-world management of Bell's palsy, emphasizing the need for adherence to established treatment guidelines.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.32115","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
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Abstract
Objective: Professional society guidelines provide clear recommendations regarding the use of high-dose steroids and/or antiviral therapy for Bell's palsy patients. This study evaluates national trends in the care of Bell's palsy patients and identifies current treatments.
Methods: A retrospective cohort study of adult Bell's palsy patients was conducted using ICD-9-CM and ICD-10-CM diagnosis codes from 2013 to 2020. These patients were continuously enrolled in the employer-sponsored MarketScan commercial or Medicare outpatient and prescription drug claims data for at least 1 year. The main outcome of interest was prescription rates of high-dose steroids and antivirals after the diagnosis date.
Results: In this cohort of 66,708 adult Bell's palsy patients, 29,824 (44.7%) received no treatment. 22,736 (34.1%) received combination therapy, 11,866 (17.8%) received steroids only, and 2282 (3.4%) received antivirals only. Males were more likely to receive combination therapy. 51.9% of Bell's palsy patients in this cohort received the AAO-recommended treatment of steroids within 72 h of diagnosis. Patients in the Southern and Western United States were more commonly prescribed combination therapy. Comorbidities such as cerebrovascular disease and symptoms like ear pain were associated with a higher likelihood of receiving combination therapy. Treatment initiation, particularly for steroids, occurred on the index date, first insurance claim, in 94.56% of cases.
Conclusion: Only 51.9% of Bell's palsy patients in this cohort received the AAO-recommended treatment with high-dose steroids with or without antiviral therapy. This research provides valuable insights into the real-world management of Bell's palsy, emphasizing the need for adherence to established treatment guidelines.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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