OBJECTIVE: This study aimed to examine the level of rhinitis control and rhinitis medication utilization in patients with persistent rhinitis and to identify predictors of rhinitis control.
METHODS: A cross-sectional observational study was conducted in patients with persistent rhinitis recruited in community pharmacies. Participants completed the Rhinitis Control Assessment Test, a questionnaire on patient/rhinitis characteristics, and rhinitis medication use. A visual analog scale for nasal symptoms was also completed. Pharmacy dispensing data were used to calculate adherence to intranasal glucocorticoids. Nasal spray technique was evaluated using a standardized checklist. Predictors of rhinitis control were explored using a linear regression model.
RESULTS: A total of 1,514 patients, recruited in 215 pharmacies, participated in the study (mean age 48.7 y, 62% female). Almost 60% exhibited suboptimal rhinitis control (Rhinitis Control Assessment Test ≤ 21 of 30). A 50-mm cut-off on the visual analog scale yielded 78.1% sensitivity to identify suboptimal rhinitis control. Participants most frequently used intranasal glucocorticoids (55.6%) and intranasal decongestants (47.4%). Only 10.3% of current nasal spray users demonstrated perfect technique. More than half (54.8%) of glucocorticoid users were identified as underadherent. Female sex, self-reported nasal hyperreactivity, active asthma, and use of oral/intranasal decongestants or nasal saline were identified as predictors of worse rhinitis control.
CONCLUSIONS: Suboptimal rhinitis control was common in this real-life sample of persistent rhinitis patients. Improving use of rhinitis medication may be key to increase disease control.
目的:本研究旨在研究持续性鼻炎患者的鼻炎控制水平和鼻炎药物利用情况,并确定鼻炎控制的预测因子。
方法:在社区药房招募的持续性鼻炎患者中进行了一项横断面观察性研究。参与者完成了鼻炎控制评估测试(RCAT),和一份关于患者/鼻炎特征的问卷,和鼻炎药物使用。还完成了鼻部症状的视觉模拟评分(VAS)。药房配药数据用于计算鼻内糖皮质激素的依从性。使用标准化检查表评估鼻腔喷雾技术。使用线性回归模型探索鼻炎控制的预测因素。
结果:共1514例患者,在215家药店招募,参加了这项研究(平均年龄48.7岁,62%女性)。几乎60%的鼻炎控制不佳(RCAT≤21/30)。VAS上的50mm截止值产生78.1%的敏感性,以识别次优的鼻炎控制。参与者最常使用鼻内糖皮质激素(55.6%)和鼻内减充血剂(47.4%)。目前只有10.3%的鼻喷雾剂使用者表现出完美的技术。超过一半(54.8%)的糖皮质激素使用者被确定为粘附不足。女性性别,自我报告的鼻腔高反应性,活动性哮喘,使用口服/鼻内减充血剂或鼻腔盐水被确定为鼻炎控制较差的预测因素。
结论:在持续性鼻炎患者的现实生活样本中,鼻炎控制欠佳是常见的。改善鼻炎药物的使用可能是提高疾病控制的关键。