Self-medication in persistent rhinitis: overuse of decongestants in half of the patients.

Abstract

BACKGROUND:

Patients with rhinitis often self-medicate with over-the-counter drugs, however this self-treating population has remained largely unstudied.

OBJECTIVE:

To characterize individuals self-medicating persistent rhinitis and to determine the prevalence of and risk factors for intranasal decongestant overuse within this population.

METHODS:

A cross-sectional observational study of individuals self-medicating persistent rhinitis (defined according to the Allergic Rhinitis and its Impact on Asthma guidelines). Participants (n = 895) completed a self-administered questionnaire to assess current symptoms, rhinitis medication, and previous physician diagnosis. Intranasal decongestant overuse was defined as daily use for at least 1 year.

RESULTS:

The vast majority of subjects (95%) had moderate-to-severe rhinitis. Nasal congestion was the predominant symptom (median visual analog scale, 6.6 cm; interquartile range, 3.4 cm). Sixty-five percent had had their current nasal problems for more than 5 years. Approximately 80% had a physician diagnosis (mainly allergic rhinitis or rhinosinusitis). The prevalence of intranasal decongestant overuse was high (49%), despite the fact that most of the patients (80%) were educated about the limit on duration of use. Use of intranasal glucocorticosteroids was inversely related to being an overuser (odds ratio 0.24 [95% CI, 0.17-0.35]). The risk of intranasal decongestant overuse also was reduced by use of other medications (oral H1 antihistamines and decongestants), use of nasal saline solution, and more symptoms of itchy and/or runny eyes or colored mucus. Risk was increased by a more severely blocked nose, longer duration of symptoms, the presence of sleep disturbance, higher body mass index, and previous advice to limit the duration of intranasal decongestant use.

CONCLUSION:

Half of the individuals self-medicating persistent rhinitis overused intranasal decongestants, despite the fact that they were educated about the limit on duration of use.

• Authors: Els Mehuys, Philippe Gevaert, Guy Brusselle, Thierry Van Hees, Els Adriaens, Thierry Christiaens, Luc Van Bortel, Inge Van Tongelen, Jean-Paul Remon, Koen Boussery
• Journal: The journal of allergy and clinical immunology. In practice (J Allergy Clin Immunol Pract) 2014 May-Jun Vol. 2 Issue 3 Pg. 313-9 ISSN: 2213-2201 [Electronic] United States
• PMID: 24811023 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Nasal Decongestants
• Nonprescription Drugs

Topics

• Adolescent
• Adult
• Aged
• Belgium
• Cross-Sectional Studies
• Drug Administration Schedule
• Female
• Humans
• Male
• Middle Aged
• Nasal Decongestants (administration & dosage, therapeutic use)
• Nonprescription Drugs (therapeutic use)
• Rhinitis (drug therapy)
• Self Medication (methods, statistics & numerical data)
• Surveys and Questionnaires
• Young Adult