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Olfactory training ball improves adherence and olfactory outcomes in post-infectious olfactory dysfunction

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Abstract

Purpose

In an effort to make olfactory training (OT) simpler, we designed an ‘olfactory training ball’ (OTB)—a baseball-size ball with four odor-containing tubes to use in OT. The study aimed to investigate the effects of OT with the OTB in comparison to classical OT with special attention to the effects of adherence to OT on olfactory outcome measures.

Methods

Sixty patients with olfactory dysfunction following infections of the upper respiratory tract received OT either with classical methods—sniffing odors from jars (COT)—or the OTB for 12 weeks. Patients exposed themselves to the odors for 5 min twice daily. Adherence was measured with a modified version of the Morisky scale. Before and after OT, all patients underwent extensive olfactory testing using the Sniffin’ Sticks test.

Results

At the end of the 12 weeks of OT, TDI composite score (22.1 ± 2.8 vs. 19.9 ± 4.7, P = 0.044) and odor discrimination subtest scores (9.1 ± 1.8 vs.7.6 ± 2.5, P = 0.013) of the OTB group were significantly higher than that of the COT group. Adequate adherence to OT was significantly higher in patients receiving OTB when compared to those receiving COT (63% vs. 30%, P = 0.019).

Conclusion

The present study shows that a novel OT device, the OTB, provides better adherence to the training process compared to COT. Moreover, findings of the current study show that better adherence to the OT process is associated with better olfactory outcomes.

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References

  1. Youngentob SL, Kent PF (1995) Enhancement of odorant-induced mucosal activity patterns in rats trained on an odorant identification task. Brain Res 670(1):82–88

    Article  CAS  Google Scholar 

  2. Hudson R, Distel H (1998) Induced peripheral sensitivity in the developing vertebrate olfactory system. Ann N Y Acad Sci 855(1):109–115

    Article  CAS  Google Scholar 

  3. Altundag A, Cayonu M, Kayabasoglu G, Salihoglu M, Tekeli H, Saglam O, Hummel T (2015) Modified olfactory training in patients with postinfectious olfactory loss. Laryngoscope 125(8):1763–1766

    Article  Google Scholar 

  4. Konstantinidis I, Tsakiropoulou E, Bekiaridou P, Kazantzidou C, Constantinidis J (2013) Use of olfactory training in post-traumatic and postinfectious olfactory dysfunction. Laryngoscope 123(12):E85–90. https://doi.org/10.1002/lary.24390

    Article  PubMed  Google Scholar 

  5. Langdon C, Lehrer E, Berenguer J, Laxe S, Alobid I, Quinto L, Marino-Sanchez F, Bernabeu M, Marin C, Mullol J (2018) Olfactory training in post-traumatic smell impairment: mild improvement in threshold performances: results from a randomized controlled trial. J Neurotrauma 35(22):2641–2652. https://doi.org/10.1089/neu.2017.5230

    Article  PubMed  Google Scholar 

  6. Oleszkiewicz A, Hanf S, Whitcroft KL, Haehner A, Hummel T (2018) Examination of olfactory training effectiveness in relation to its complexity and the cause of olfactory loss. Laryngoscope 128(7):1518–1522. https://doi.org/10.1002/lary.26985

    Article  PubMed  Google Scholar 

  7. Damm M, Pikart LK, Reimann H, Burkert S, Goktas O, Haxel B, Frey S, Charalampakis I, Beule A, Renner B, Hummel T, Huttenbrink KB (2014) Olfactory training is helpful in postinfectious olfactory loss: a randomized, controlled, multicenter study. Laryngoscope 124(4):826–831. https://doi.org/10.1002/lary.24340

    Article  PubMed  Google Scholar 

  8. Konstantinidis I, Tsakiropoulou E, Constantinidis J (2016) Long term effects of olfactory training in patients with post-infectious olfactory loss. Rhinology 54(2):170–175. https://doi.org/10.4193/Rhin15.264

    Article  CAS  PubMed  Google Scholar 

  9. Hummel T, Rissom K, Reden J, Hahner A, Weidenbecher M, Huttenbrink KB (2009) Effects of olfactory training in patients with olfactory loss. Laryngoscope 119(3):496–499. https://doi.org/10.1002/lary.20101

    Article  PubMed  Google Scholar 

  10. Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G (1997) 'Sniffin' sticks': olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 22(1):39–52. https://doi.org/10.1093/chemse/22.1.39

    Article  CAS  PubMed  Google Scholar 

  11. Kobal G, Klimek L, Wolfensberger M, Gudziol H, Temmel A, Owen CM, Seeber H, Pauli E, Hummel T (2000) Multicenter investigation of 1,036 subjects using a standardized method for the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds. Eur Arch Oto-rhino-laryngol 257(4):205–211

    Article  CAS  Google Scholar 

  12. Morisky DE, Green LW, Levine DM (1986) Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 24(1):67–74

    Article  CAS  Google Scholar 

  13. Oleszkiewicz A, Schultheiss T, Schriever VA, Linke J, Cuevas M, Hahner A, Hummel T (2018) Effects of "trigeminal training" on trigeminal sensitivity and self-rated nasal patency. Eur Arch Oto-rhino-laryngol 275(7):1783–1788. https://doi.org/10.1007/s00405-018-4993-5

    Article  Google Scholar 

  14. Dobbels F, Van Damme-Lombaert R, Vanhaecke J, De Geest S (2005) Growing pains: non-adherence with the immunosuppressive regimen in adolescent transplant recipients. Pediatr Transplant 9(3):381–390. https://doi.org/10.1111/j.1399-3046.2005.00356.x

    Article  PubMed  Google Scholar 

  15. Bosworth HB, Zullig LL, Mendys P, Ho M, Trygstad T, Granger C, Oakes MM, Granger BB (2016) Health information technology: meaningful use and next steps to improving electronic facilitation of medication adherence. JMIR Med Inform 4(1):e9. https://doi.org/10.2196/medinform.4326

    Article  PubMed  PubMed Central  Google Scholar 

  16. Perez-Jover V, Mira JJ, Carratala-Munuera C, Gil-Guillen VF, Basora J, Lopez-Pineda A, Orozco-Beltran D (2018) Inappropriate use of medication by elderly, polymedicated, or multipathological patients with chronic diseases. Int J Environ Res Public Health 15(2):310. https://doi.org/10.3390/ijerph15020310

    Article  PubMed Central  Google Scholar 

  17. Rubin RR (2005) Adherence to pharmacologic therapy in patients with type 2 diabetes mellitus. Am J Med 118(Suppl 5A):27s–34s. https://doi.org/10.1016/j.amjmed.2005.04.012

    Article  CAS  PubMed  Google Scholar 

  18. van der Wal MH, Jaarsma T, van Veldhuisen DJ (2005) Non-compliance in patients with heart failure; how can we manage it? Eur J Heart Fail 7(1):5–17. https://doi.org/10.1016/j.ejheart.2004.04.007

    Article  PubMed  Google Scholar 

  19. Bova CA, Fennie KP, Knafl GJ, Dieckhaus KD, Watrous E, Williams AB (2005) Use of electronic monitoring devices to measure antiretroviral adherence: practical considerations. AIDS Behav 9(1):103–110. https://doi.org/10.1007/s10461-005-1685-0

    Article  PubMed  Google Scholar 

  20. Grant RW, Singer DE, Meigs JB (2005) Medication adherence before an increase in antihypertensive therapy: a cohort study using pharmacy claims data. Clin Ther 27(6):773–781. https://doi.org/10.1016/j.clinthera.2005.06.004

    Article  PubMed  Google Scholar 

  21. Yan XG, Gao X, Sun ZF, Guo YC, Yao LY, Liu J, Xiao W, Lyu QW, Wei YX (2018) Efficacy and associated factors of olfactory training in the treatment of olfactory dysfunction. Chin J Otorhinolaryngol Head Neck Surg 53(11):815–819. https://doi.org/10.3760/cma.j.issn.1673-0860.2018.11.004

    Article  CAS  Google Scholar 

  22. Hummel T, Stupka G, Haehner A, Poletti SC (2018) Olfactory training changes electrophysiological responses at the level of the olfactory epithelium. Rhinology 56(4):330–335. https://doi.org/10.4193/Rhin17.163

    Article  CAS  PubMed  Google Scholar 

  23. Pantuzza LL, Ceccato M, Silveira MR, Junqueira LMR, Reis AMM (2017) Association between medication regimen complexity and pharmacotherapy adherence: a systematic review. Eur J Clin Pharmacol 73(11):1475–1489. https://doi.org/10.1007/s00228-017-2315-2

    Article  PubMed  Google Scholar 

  24. Francis S, Rolls ET, Bowtell R, McGlone F, O'Doherty J, Browning A, Clare S, Smith E (1999) The representation of pleasant touch in the brain and its relationship with taste and olfactory areas. NeuroReport 10(3):453–459

    Article  CAS  Google Scholar 

  25. Kollndorfer K, Kowalczyk K, Hoche E, Mueller CA, Pollak M, Trattnig S, Schopf V (2014) Recovery of olfactory function induces neuroplasticity effects in patients with smell loss. Neural Plast 2014:140419. https://doi.org/10.1155/2014/140419

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kollndorfer K, Fischmeister FP, Kowalczyk K, Hoche E, Mueller CA, Trattnig S, Schopf V (2015) Olfactory training induces changes in regional functional connectivity in patients with long-term smell loss. NeuroImage Clin 9:401–410. https://doi.org/10.1016/j.nicl.2015.09.004

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Osterbauer RA, Matthews PM, Jenkinson M, Beckmann CF, Hansen PC, Calvert GA (2005) Color of scents: chromatic stimuli modulate odor responses in the human brain. J Neurophysiol 93(6):3434–3441. https://doi.org/10.1152/jn.00555.2004

    Article  PubMed  Google Scholar 

  28. Gulpen AJW, Ten Cate H, Henskens YMC, van Oerle R, Wetzels R, Schalla S, Crijns HJ, Ten Cate-Hoek AJ (2019) The daily practice of direct oral anticoagulant use in patients with atrial fibrillation; an observational cohort study. PLoS ONE 14(6):e0217302. https://doi.org/10.1371/journal.pone.0217302

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Jungst C, Graber S, Simons S, Wedemeyer H, Lammert F (2019) Medication adherence among patients with chronic diseases: a survey-based study in pharmacies. QJM. https://doi.org/10.1093/qjmed/hcz058

    Article  PubMed  Google Scholar 

  30. Kalkan E, Kavak Budak F (2019) The effect of insights on medication adherence in patients with schizophrenia. Perspect Psychiatr Care. https://doi.org/10.1111/ppc.12414

    Article  PubMed  Google Scholar 

  31. Shaha KC, Sultana S, Saha SK, Shahidullah SM, Jyoti BK (2019) Patient characteristics associated with medication adherence to anti-diabetic drugs. Mymensingh Med J 28(2):423–428

    CAS  PubMed  Google Scholar 

  32. Sieben A, van Onzenoort HA, van Dulmen S, van Laarhoven C, Bredie SJ (2019) A nurse-based intervention for improving medication adherence in cardiovascular patients: an evaluation of a randomized controlled trial. Patient Prefer Adher 13:837–852. https://doi.org/10.2147/ppa.s197481

    Article  Google Scholar 

  33. Uchmanowicz B, Jankowska EA, Uchmanowicz I, Morisky DE (2019) Self-reported medication adherence measured with Morisky medication adherence scales and its determinants in hypertensive patients aged ≥ 60 years: a systematic review and meta-analysis. Front Pharmacol 10:168. https://doi.org/10.3389/fphar.2019.00168

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

The authors declare that they received no funding for the present study.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Istanbul Sancaktepe Training and Research Hospital, Emek,Namık Kemal Cd. No: 7, Sancaktepe, 34785, Istanbul, Turkey

    Ozlem Saatci

  2. Department of Otorhinolaryngology, Biruni University, Istanbul, Turkey

    Aytug Altundag

  3. Department of Neurology, Istanbul Medipol University, Istanbul, Turkey

    Ozge Arici Duz

  4. Smell and Taste Clinic, Department of Otorhinolaryngology, Dresden University of Technology, Dresden, Germany

    Thomas Hummel

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  1. Ozlem Saatci
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  2. Aytug Altundag
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  3. Ozge Arici Duz
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  4. Thomas Hummel
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by OS, OAD AA, and TH. The first draft of the manuscript was written by OS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ozlem Saatci.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

Written informed consent was obtained from all participants and the study protocol was approved by the Institutional Ethics Committee (10840098-604.01.01-E.12637). The study was carried out in accordance with the ethical standards laid down in the 1964 declaration of Helsinki and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Saatci, O., Altundag, A., Duz, O.A. et al. Olfactory training ball improves adherence and olfactory outcomes in post-infectious olfactory dysfunction. Eur Arch Otorhinolaryngol 277, 2125–2132 (2020). https://doi.org/10.1007/s00405-020-05939-3

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  • DOI: https://doi.org/10.1007/s00405-020-05939-3

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