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变应性鼻炎患者使用鼻用糖皮质激素的安全性问题

Safety Concerns of Nasal Corticosteroids Usage in Patients With Allergic Rhinitis.

作者信息

Almutairi Talal A, Aldayel Abdulaziz A, Aldayel Abdulrahman S, Alotaibi Fahad, Alhussain Hamad A

机构信息

Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU.

Otolaryngology, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU.

出版信息

Cureus. 2020 Nov 23;12(11):e11651. doi: 10.7759/cureus.11651.

Abstract

Background Intranasal corticosteroids (INCSs) are the first-line treatment for patients with moderate to severe conditions of allergic rhinitis (AR) as per current guidelines. However, patients' knowledge and practice towards the safety of such medications remains ambiguous. Therefore, this study was undertaken to identify the awareness of and knowledge about the safety of nasal corticosteroid usage in patients with allergic rhinitis as well as their adherence to taking the medication. Materials and methods We conducted a cross-sectional study from June to September 2020 at Imam Mohammad Ibn Saud Islamic University Medical Center, Riyadh, Kingdom of Saudi Arabia. Data were collected through questionnaire-based surveys, and a total of 375 patients were enrolled in the study. The eligibility criteria included all adult patients diagnosed with allergic rhinitis. Results Most of the patients had used intranasal corticosteroids. However, only two-fifths of patients stated these medications were effective and only 27% thought they were safe to use. More than half of the patients expressed concerns about using intranasal corticosteroids; however, there was no difference among the patients when asked if their concerns made them discontinue their medication. The majority of patients (73.3%) did not receive appropriate advice on how to use intranasal corticosteroids, but most were compliant with the therapy regardless of their uncertainty about the medication's safety (71.5%). Most patients reported a benefit of using intranasal corticosteroids (71.5%). Half of the patients (53.9%) reported being aware of a special technique for how to use a nasal spray, but the nonsmokers were more knowledgeable about the techniques than the smokers (p = 0.007). Conclusion The patients' knowledge about, adherence to, and perceptions of intranasal corticosteroid use were found to be suboptimal. Patients' age, gender, socioeconomic status, education level, and smoking status were recognized as potential barriers to a positive perception of and adherence to the treatment plan. Corrective measures are needed to ensure better health outcomes.

摘要

背景 根据当前指南,鼻用糖皮质激素(INCSs)是中重度过敏性鼻炎(AR)患者的一线治疗药物。然而,患者对这类药物安全性的认知和实际做法仍不明确。因此,本研究旨在确定过敏性鼻炎患者对鼻用糖皮质激素使用安全性的知晓情况和认识,以及他们对服药的依从性。

材料与方法 2020年6月至9月,我们在沙特阿拉伯王国利雅得的伊玛目穆罕默德·本·沙特伊斯兰大学医学中心进行了一项横断面研究。通过问卷调查收集数据,共有375名患者纳入本研究。纳入标准包括所有诊断为过敏性鼻炎的成年患者。

结果 大多数患者使用过鼻用糖皮质激素。然而,只有五分之二的患者表示这些药物有效,只有27%的患者认为使用这些药物是安全的。超过一半的患者对使用鼻用糖皮质激素表示担忧;然而,当被问及这些担忧是否导致他们停药时,患者之间没有差异。大多数患者(73.3%)没有得到关于如何使用鼻用糖皮质激素的适当建议,但大多数患者尽管对药物安全性存在疑虑,仍坚持治疗(71.5%)。大多数患者报告使用鼻用糖皮质激素有好处(71.5%)。一半的患者(53.9%)报告知道如何使用鼻喷雾剂的特殊技巧,但不吸烟者比吸烟者对这些技巧的了解更多(p = 0.007)。

结论 发现患者对鼻用糖皮质激素的知识、依从性和认知情况不理想。患者的年龄、性别、社会经济地位、教育水平和吸烟状况被认为是对治疗方案产生积极认知和依从性的潜在障碍。需要采取纠正措施以确保更好的健康结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6974/7686935/bf3d9e03dfd7/cureus-0012-00000011651-i01.jpg

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