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Bao-Anh Nguyen-Khoa, PharmD, MPH; Earl L. Goehring Jr, BA; Ruby M. Vendiola, BS; John C. Pezzullo, PhD; Judith K. Jones, MD, PhD

Arch Otolaryngol Head Neck Surg. 2007;133(8):748-757.

Objective  To report the rates of medical claims for sense of smell disturbance (SD) and their association with diseases and medications in a managed care population.

Design  Descriptive determination of demographics, prevalence, and incidence of SD and case-control analysis of risk factors. Preselected drug and disease groups were entered into a stepwise regression model to determine risk factors for SD.

Setting  Managed care organizations in the United States.

Patients  Patients identified through medical claims within IMS Health's LifeLink: Integrated Claims Solution (IMS) and i3 Magnifi Private Managed Care Organizations (MCO) medical insurance databases for 3-year observation periods.

Main Outcome Measures  Prevalence and incidence of smell disturbance; adjusted odds ratios and 95% confidence intervals (CIs) of associated conditions and medications.

Results  The mean annual prevalence rate of SD was 26.2 per 100 000 for IMS (95% CI, 23.1-29.6) and 17.2 per 100 000 for MCO (95% CI, 15.6-18.7). The mean annual incidence per 100 000 was 26.3 for IMS (95% CI, 23.1-29.8) and 15.9 for MCO (95% CI, 14.5-17.5). The 5 strongest risk factors for SD were chronic sinusitis, oropharyngeal inflammatory disorders, other upper respiratory tract disease excluding sinusitis, cerebrovascular disease, and systemic viral disease. The regression model also retained 3 drug groups (corticosteroids, calcium channel blockers, and nasal and/or sinus products) among the significant risk factors for the presence of SD.

Conclusions  The annual prevalence and incidence rates of SD are lower than prior estimates partly owing to reliance on specific medical claims. A number of conditions preceding the diagnosis of SD were significantly associated with the condition. Uses of certain medications were also risk factors for SD compared with controls.

Author Affiliations: The Degge Group Ltd, Arlington, Virginia (Drs Nguyen-Khoa and Jones, Mr Goehring, and Ms Vendiola); and Department of Biomathematics and Biostatistics, Georgetown University, Washington, DC (Dr Pezzullo).