Stakeholders’ views of recurrent sore throat, tonsillitis and their management: a qualitative interview study for the NAtional Trial of Tonsillectomy IN Adults (NATTINA Part 1)

Objectives - To determine the impact of recurrent sore throats and tonsillitis in adults and stakeholder views of treatment pathways. Design - Qualitative semistructured interview design reporting novel data from a feasibility study for a UK national trial of tonsillectomy in adults. Setting - Nine study sites linked to ear, nose and throat departments in National Health Service hospitals located across the United Kingdom. Participants - Fifteen patients, 11 general practitioners and 22 ear, nose and throat staff consented to in-depth interviews, which were analysed using a framework analysis approach. Main outcome measures - Views of stakeholder groups. Results - Recurrent sore throats were reported to severely impact patients’ family, work and social life. Ear, nose and throat staff stated that patients faced increasing barriers to secondary care service access. General practitioners were under pressure to reduce ‘limited clinical value’ surgical procedures. Conclusions -The findings from this study suggest that there is a disconnect between the attitudes of the stakeholders and the reality of recurrent sore throat, tonsillectomy procedures and service provision. More evidence for the role of tonsillectomy is needed from randomised controlled trials to determine whether it should continue to be ranked as a procedure of limited clinical effectiveness.