Booklet simplifies dizziness care

By Caroline Price

Giving patients with chronic dizziness a simple booklet to help them learn vestibular rehabilitation exercises is a highly cost-effective alternative to the usual way of treating them, report researchers in the BMJ.

The booklet self-management approach, with telephone support from experienced vestibular therapists, resulted in at least as good improvements in vertigo symptoms as usual care did after 12 weeks.

Furthermore, use of the booklet with or without telephone support yielded greater improvements by 1 year.

The study, which included 337 patients in total, also showed that both the booklet-only approach and booklet with additional telephone support were likely to be cost-effective, report Professor Lucy Yardley (University of Southampton) and colleagues.

They estimate that one patient would benefit from the booklet and telephone support for every five patients treated over a year.

"Typically, 80-90% of patients with dizziness are managed in primary care, chiefly by reassurance and treatment for symptomatic relief," they explain. No effective drugs are currently available for long-term use and vestibular rehabilitation usually involves a costly and lengthy referral process, the team adds.

"This intervention could reduce the number of patients who need referral to secondary care for more intensive investigation and management," write Professor Yardley and colleagues. "At a minimum, the simple provision of a booklet explaining to patients how to self manage their symptoms using vestibular rehabilitation exercises seems to have lasting benefits, without incurring any additional resource use relative to routine care."

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