Recent Trends in Ménière's Disease Management in India: Results from the DIRECTION Cross-sectional Online Survey.

Abstract

Background: Ménière's disease (MD) is an inner ear ailment that can be effectively controlled with appropriate treatment and disease management.

Objectives: The DIRECTION (Differential dIagnosis for compREhension of Causes, Triggers, and Indications Of MéNière's disease) study was designed to highlight the major causes, symptoms, treatments, and disease management of MD from the perspective of clinical physicians and healthcare practitioners (HCPs) across India.

Materials and methods: A national, cross-sectional survey was conducted to record the responses of HCPs regarding MD symptoms, patient complaints, diagnosis, and dosing regimen of preferred medication. The survey responses were recorded from consulting physicians with specialties in ear, nose, and throat, chest, and neurology across the northern, southern, eastern, and western regions of India.

Results: According to 89% of the HCPs who participated in this nationwide survey, 10%-40% of the patients visited them with dizziness and vertigo as primary symptoms for MD. Nearly 64% of the physicians diagnosed patients based on their symptom history, generally when the disease has progressed to its middle stage. The majority of the clinicians prefer 16 mg betahistine at twice-a-day frequency. Most of the respondents agreed that there was no significant impact of COVID-19 infection on initiation and progression of MD.

Conclusion: Vertigo and dizziness are the most common symptoms of MD, and the disease is generally detected during its middle stage. Patient counseling and education, being one of the most important aspects in disease management, must be promoted.