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Does intranasal steroid spray technique affect side effects and compliance? Results of a patient survey

Published online by Cambridge University Press:  20 October 2017

V Ganesh
Affiliation:
University of Aberdeen School of Medicine and Dentistry, Scotland, UK
A Banigo*
Affiliation:
Department of Otolaryngology, Aberdeen Royal Infirmary, Scotland, UK
A E L McMurran
Affiliation:
Department of Otolaryngology, Aberdeen Royal Infirmary, Scotland, UK
M Shakeel
Affiliation:
Department of Otolaryngology, Aberdeen Royal Infirmary, Scotland, UK
B Ram
Affiliation:
Department of Otolaryngology, Aberdeen Royal Infirmary, Scotland, UK
*
Address for correspondence: Mr A Banigo, Department of Otolaryngology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, Scotland, UK Fax: 01224 554569 E-mail: [email protected]

Abstract

Background:

Intranasal steroid sprays are fundamental in the medical management of inflammatory rhinological conditions. Side effects are common, but these may be related to the method of application rather than the medication itself.

Methods:

A survey was distributed to patients using intranasal steroid sprays at the ENT out-patient clinic at Aberdeen Royal Infirmary over three months. This evaluated the spray technique used, side effects and compliance.

Results:

Of 103 patients, 22 patients (21.4 per cent) reported side effects, including nasal irritation and epistaxis. Of the 20 patients with epistaxis, 80 per cent used an ipsilateral hand technique (p = 0.01). Thirty patients demonstrated poor compliance because of lack of symptom improvement or side effects. Seventy-seven per cent of this group used the ipsilateral hand technique.

Conclusion:

Patients who used their ipsilateral hand to apply the intranasal steroid spray were more likely to develop epistaxis and have poor compliance than those who used other techniques. Patients who struggle with compliance because of side effects should avoid this method of intranasal steroid application.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented at the ENT Scotland Summer Meeting, 13 May 2016, Dunblane, Scotland, UK.

References

1 Mygind, N. Glucocorticosteroids and rhinitis. Allergy 1993;48:476–90Google Scholar
2 Bousquet, J, Khaltaev, N, Cruz, AA, Denburg, J, Fokkens, WJ, Togias, A et al. Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen. Allergy 2008;63(suppl 86):8160 CrossRefGoogle Scholar
3 Fokkens, WJ, Lund, VJ, Mullol, J, Bachert, C, Alobid, I, Baroody, F et al. European position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl 2012;23:1298 Google Scholar
4 Chong, LY, Head, K, Hopkins, C, Philpott, C, Burton, MJ, Schilder, AG. Different types of intranasal steroids for chronic rhinosinusitis. Cochrane Database Syst Rev 2016;(4):CD011993 Google ScholarPubMed
5 Sheth, K. Evaluating the safety of intranasal steroids in the treatment of allergic rhinitis. Allergy Asthma Clin Immunol 2008;4:125–9CrossRefGoogle ScholarPubMed
6 Al Sayyad, JJ, Fedorowicz, Z, Alhashimi, D, Jamal, A. Topical nasal steroids for intermittent and persistent allergic rhinitis in children. Cochrane Database Syst Rev 2007;(1):CD003163 Google Scholar
7 Chong, LY, Head, K, Hopkins, C, Philpott, C, Schilder, AG, Burton, MJ. Intranasal steroids versus placebo or no intervention for chronic rhinosinusitis. Cochrane Database Syst Rev 2016;(4):CD011996 Google ScholarPubMed
8 Bateman, ND, Whymark, AD, Clifton, NJ, Woolford, TJ. A study of intranasal distribution of azelastine hydrochloride aqueous nasal spray with different spray techniques. Clin Otolaryngol 2002;27:327–30CrossRefGoogle ScholarPubMed
9 Tsikoudas, A, Homer, JJ. The delivery of topical nasal sprays and drops to the middle meatus: a semiquantitative analysis. Clin Otolaryngol 2001;26:294–7CrossRefGoogle Scholar
10 Aggarwal, R, Cardozo, A, Homer, JJ. The assessment of topical nasal drug distribution. Clin Otolaryngol 2004;29:201–5CrossRefGoogle ScholarPubMed
11 Benninger, MS, Hadley, JA, Osguthorpe, JD, Marple, BF, Leopold, DA, Derebery, MJ et al. Techniques of intranasal steroid use. Otolaryngol Head Neck Surg 2004;130:524 Google Scholar
12 Benninger, MS. Epistaxis and its relationship to handedness with use of intranasal steroid spray. Ear Nose Throat J 2008;87:463–5Google Scholar
13 Nabi, S, Rotenberg, BW, Vukin, I, Payton, K, Bureau, Y. Nasal spray adherence after sinus surgery: problems and predictors. J Otolaryngol Head Neck Surg 2012;41:S49–55Google ScholarPubMed
14 Capanoglu, M, Dibek Misirlioglu, E, Toyran, M, Civelek, E, Kocabas, CN. Evaluation of inhaler technique, adherence to therapy and their effect on disease control among children with asthma using metered dose or dry powder inhalers. J Asthma 2015;52:838–45Google Scholar
15 Bosnic-Anticevich, SZ, Sinha, H, So, S, Reddel, HK. Metered-dose inhaler technique: the effect of two educational interventions delivered in community pharmacy over time. J Asthma 2010;47:251–6CrossRefGoogle ScholarPubMed