Published February 28, 2021 | Version https://impactfactor.org/PDF/IJPCR/13/IJPCR,Vol13,Issue1,Article4.pdf
Journal article Open

Educating Patient Regarding the Use of INCS Technique for Allergic Rhinitis: An Intervention Study

Authors/Creators

  • 1. Senior Resident, Department of ENT, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India

Description

Aim: The aim of the study to patient education on nasal spray technique for allergic rhinitis. Methods: A cross-sectional prospective study was conducted in the Department of ENT, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India, for 1 year. AR who had never been on steroid nasal spray treatment was included in this study. All patients were treated with intranasal mometasone furoate monohydrate (Nasonex) manufacture by MSD. The dose prescribed was two puffs in each nostril once daily. Each puff contains 50 mcg of Mometasone furoate monohydrate. The patients were reviewed and assessed 4 times after the initial visit. The interval between each visit was 6 weeks. Results: A total of 100 patients satisfied the inclusion criteria and consented to participate in this study. Patients were between 18 to 60 years old (mean=31.2 years) and among them 38 (38%) were male patients and 62 (62%) were female patients. Based on the 2008 ARIA guidelines, 91 (91%) patients were diagnosed with moderate-severe persistent (MSP) AR, 3 (3%) had moderate- severe intermittent (MSI) AR while 6 (6%) had mild persistent (MP) AR. During the 3rd visit despite re-education, only 27% of participants were able to show the correct techniques. However, by the 3rd and 4th visit, a good improvement was seen as more were able to demonstrate the INCS delivery technique correctly. At the end of the study, all 100 (100%) patients successfully applied and demonstrated proper technique of INCS using the Hospital Putrajaya INCS spray delivery technique.  Baseline TNSS on V1 showed that 69 patients (71.9%) came with severe symptoms. Conclusion: The present study strongly advocates that patient are effectively counseled about proper INCS spray application technique when they receive a nasal spray. Patients must be given clear instructions for correct administration.

 

 

 

Abstract (English)

Aim: The aim of the study to patient education on nasal spray technique for allergic rhinitis. Methods: A cross-sectional prospective study was conducted in the Department of ENT, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India, for 1 year. AR who had never been on steroid nasal spray treatment was included in this study. All patients were treated with intranasal mometasone furoate monohydrate (Nasonex) manufacture by MSD. The dose prescribed was two puffs in each nostril once daily. Each puff contains 50 mcg of Mometasone furoate monohydrate. The patients were reviewed and assessed 4 times after the initial visit. The interval between each visit was 6 weeks. Results: A total of 100 patients satisfied the inclusion criteria and consented to participate in this study. Patients were between 18 to 60 years old (mean=31.2 years) and among them 38 (38%) were male patients and 62 (62%) were female patients. Based on the 2008 ARIA guidelines, 91 (91%) patients were diagnosed with moderate-severe persistent (MSP) AR, 3 (3%) had moderate- severe intermittent (MSI) AR while 6 (6%) had mild persistent (MP) AR. During the 3rd visit despite re-education, only 27% of participants were able to show the correct techniques. However, by the 3rd and 4th visit, a good improvement was seen as more were able to demonstrate the INCS delivery technique correctly. At the end of the study, all 100 (100%) patients successfully applied and demonstrated proper technique of INCS using the Hospital Putrajaya INCS spray delivery technique.  Baseline TNSS on V1 showed that 69 patients (71.9%) came with severe symptoms. Conclusion: The present study strongly advocates that patient are effectively counseled about proper INCS spray application technique when they receive a nasal spray. Patients must be given clear instructions for correct administration.

 

 

 

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https://impactfactor.org/PDF/IJPCR/13/IJPCR,Vol13,Issue1,Article4.pdf

Dates

Accepted
2021-02-20

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References

  • 1. Sheth K. Evaluating the safety of intranasal steroids in the treatment of allergic rhinitis. Allergy Asthma Clin Immunol. 2008;4(3):125–129. 2. Mehuys E, Gevaert P, Brusselle G, et al. Self-medication in persistent rhinitis: overuse of decongestants in half of the patients. J Allergy Clin Immunol Pract. 2014;2(3):313–319. 3. Tran NP, Vickery J, Blaiss MS. Management of rhinitis: allergic and non-allergic. Allergy Asthma Immunol Res. 2011;3(3):148–156. 4. Lenz D, Cardoso KS, Bitti ACR, Andrade TU. Evaluation of the use of topic nasal decongestants in university students from health sciences courses. Braz J Pharm Sci. 2011;47(4):761– 766. 5. Bridgeman MB. Overcoming barriers to intranasal corticosteroid use in patients with uncontrolled allergic rhinitis. Integr Pharm Res Pract. 2017; 6:109–119. 6. Hellings PW, Dobbels F, Denhaerynck K, Piessens M, Ceuppens JL, De Geest S. Explorative study on patient's perceived knowledge level, expectations, preferences and fear of side effects for treatment for allergic rhinitis. Clin Transl Allergy. 2012;2(1):1–8. 7. Garlapati RR, Lee HP, Chong FH, Wang DY. Indicators for the correct usage of intranasal medications: a computational fluid dynamics study. Laryngoscope. 2009;119(10):1975– 1982. 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; 27:327–330. 9. Rudmik L, Xu Y, Liu M, Bird C, Kukec E, Quan H. Utilization patterns of topical intranasal steroid therapy for chronic rhinosinusitis a canadian population-based analysis. JAMA Otolaryngol Head Neck Surg. 2016;142(11):1056–1062. 10. Klossek JM, Neukirch F, Pribil C, et al. Prevalence of nasal polyposis in France: a cross-sectional, case-control study. Allergy Eur J Allergy Clin Immunol. 2005;60(2):233–237. 11. Benninger MS, Ahmad N, Marple BF. The safety of intranasal steroids. Otolaryngol Head Neck Surg. 2003;129(6):739–750. 12. Benninger MS. Epistaxis and its relationship to handedness with use of intranasal steroid spray. ENT-Ear Nose Throat J. 2008;87(8):2–4. 13. Haynes R, McDonald H, Garg A, Montague P. Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev. 2003. 14. Ansari M, Rao BS, Koju R, Shakya R. Impact of pharmaceutical intervention on inhalation technique. Kathmandu Univ J Sci Eng Technol. 2005;1(1):1– 10. 15. Rollema C, Van Roon EN, de Vries TW. Inadequate quality of administration of intranasal corticosteroid sprays. J Asthma Allergy. 2019; 12:91–94. 16. Clement FG. Standardisation Committee on Objective Assessment of the Nasal Airway, IRS, and ERS. Consensus report on acoustic rhinometry and rhinomanometry. Rhinol. 2005; 43:169-79. 17. Bousquet J, Van Cauwenberge P, Khaltaev N, Aria Workshop Group, World Health Organization. Allergic Rhinitis and Its Impact on Asthma. JAllergy Clin Immunol. 108(5):S147- 334 18. Merkus P, Ebbens FA, Muller B, Fokkens WJ. The 'best method 'of topical nasal drug delivery: comparison of seven techniques. Rhinol.2006;44(2):102-7. 19. Ganesh V, Banigo A, McMurran AEL, Shakeel M, Ram B. Does intranasal steroid spray technique affect side effects and compliance? Results of a patient survey. J Laryngol Otol. 2017;131(11):991-6. 20. Rollema C, Van Roon EN, De Vries TW. Inadequate quality of administration of intranasal corticosteroid sprays. J Asthma Allergy. 2019; 12:91-4. 21. Benninger MS, Hadley JA, Osguthorpe JD, Marple BF, Leopold DA, Derebery M.J et al. Techniques of Intranasal Steroid Use. Otolaryngol Neck Surg. 2004;130(1):5-24. 22. Chong LY, Head K, Hopkins C, Philpott C, Schilder AG, Burton MJ. Intranasal steroids versus placebo or no intervention for chronic rhinosinusitis. Cochrane ENT Group, editor. Cochrane Database Syst Rev. 2016;4:CD011996. 23. Axtell S, Haines S, Fairclough J. Effectiveness of Various Methods of Teaching Proper Inhaler Technique: The Importance of Pharmacist Counsellin. J Pharm Pract. 2017;30(2):195-201. 24. Basheti IA, Reddel HK, Armour CL, Bosnic- Anticevich SZ. Improved asthma outcomes with a simple inhaler technique intervention by community pharmacists. J Allergy Clin Immunol. 2007;119(6):1537-8. 25. McElnay JC, Scott MG, Armstrong AP, Stanford CF. Audiovisual Demonstration for Patient Counselling in The Use of Pressurised Aerosol Bronchodilator Inhalers. J Clin Pharm Ther. 1989;14(2):135-44.