Knowledge of, Attitudes towards, and Practices of Intranasal Corticosteroids Usage among the Allergic Rhinitis Patients of Northern Saudi Arabia: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Description and Sampling Strategy
2.2. Inclusion and Exclusion Criteria
2.3. Data Collection Procedure
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Akhouri, S.; House, S.A. Allergic Rhinitis. In StatPearls; StatPearls Publishing: Treasure Island, FL, USA, 2022. [Google Scholar]
- Small, P.; Keith, P.K.; Kim, H. Allergic rhinitis. Allergy Asthma Clin. Immunol. 2018, 14, 51. [Google Scholar] [CrossRef] [PubMed]
- Sultész, M.; Horváth, A.; Molnár, D.; Katona, G.; Mezei, G.; Hirschberg, A.; Gálffy, G. Prevalence of allergic rhinitis, related comorbidities and risk factors in schoolchildren. Allergy Asthma Clin. Immunol. 2020, 16, 98. [Google Scholar] [CrossRef] [PubMed]
- Kef, K.; Güven, S. The Prevalence of Allergic Rhinitis and Associated Risk Factors Among University Students in Anatolia. J. Asthma Allergy 2020, 13, 589–597. [Google Scholar] [CrossRef] [PubMed]
- Almatroudi, A.; Mousa, A.M.; Vinnakota, D.; Abalkhail, A.; Alwashmi, A.S.S.; Almatroodi, S.A.; Alhumaydhi, F.A.; Kabir, R.; Mahmud, I. Prevalence and associated factors of respiratory allergies in the Kingdom of Saudi Arabia: A cross-sectional investigation, September–December 2020. PLoS ONE 2021, 16, e0253558. [Google Scholar] [CrossRef]
- Mahnashi, T.A.; Faqihi, M.A.; Moafa, A.N.; Basudan, A.A.; Alhazmi, M.N.; Khawaji, A.F.; Haddadi, Y.M.Y. Severity and prevalence of allergic rhinitis among school children, Jazan Region Saudi Arabia. J. Fam. Med. Prim. Care 2019, 8, 663–668. [Google Scholar] [CrossRef]
- Fokkens, W.J.; Lund, V.J.; Mullol, J.; Bachert, C.; Alobid, I.; Baroody, F.; Cohen, N.; Cervin, A.; Douglas, R.; Gevaert, P.; et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 2012, 50, 1–12. [Google Scholar] [CrossRef]
- Cingi, C.; Gevaert, P.; Mösges, R.; Rondon, C.; Hox, V.; Rudenko, M.; Muluk, N.B.; Scadding, G.; Manole, F.; Hupin, C.; et al. Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report. Clin. Transl. Allergy 2017, 7, 17. [Google Scholar] [CrossRef]
- Kalmarzi, R.N.; Khazaei, Z.; Shahsavar, J.; Gharibi, F.; Tavakol, M.; Khazaei, S.; Shariat, M. The impact of allergic rhinitis on quality of life: A study in western Iran. Biomed. Res. Ther. 2017, 4, 1629–1637. [Google Scholar] [CrossRef]
- Roger, A.; Arcalá Campillo, E.; Torres, M.C.; Millan, C.; Jáuregui, I.; Mohedano, E.; Liñan, S.; Verdu, P.; Rubira, N.; Santaolalla, M.; et al. Reduced work/academic performance and quality of life in patients with allergic rhinitis and impact of allergen immunotherapy. Allergy Asthma Clin. Immunol. 2016, 12, 40. [Google Scholar] [CrossRef]
- Sikorska-Szaflik, H.; Sozańska, B. Quality of life in allergic rhinitis-children’s and their parents’ perspective in polish urban and rural population. Health Qual. Life Outcomes 2020, 18, 64. [Google Scholar] [CrossRef]
- Bosnic-Anticevich, S.; Smith, P.; Abramson, M.; Hespe, C.M.; Johnson, M.; Stosic, R.; Price, D.B. Impact of allergic rhinitis on the day-to-day lives of children: Insights from an Australian cross-sectional study. BMJ Open 2020, 10, e038870. [Google Scholar] [CrossRef] [PubMed]
- Fokkens, W.J.; Lund, V.J.; Hopkins, C.; Hellings, P.W.; Kern, R.; Reitsma, S.; Toppila-Salmi, S.; Bernal-Sprekelsen, M.; Mullol, J. Executive summary of EPOS 2020 including integrated care pathways. Rhinology 2020, 58, 82–111. [Google Scholar] [CrossRef] [PubMed]
- Chmielik, L.P.; Mielnik-Niedzielska, G.; Kasprzyk, A.; Stankiewicz, T.; Niedzielski, A. Health-Related Quality of Life Assessed in Children with Chronic Rhinitis and Sinusitis. Children 2021, 8, 1133. [Google Scholar] [CrossRef] [PubMed]
- Hossenbaccus, L.; Linton, S.; Garvey, S.; Ellis, A.K. Towards definitive management of allergic rhinitis: Best use of new and established therapies. Allergy Asthma Clin. Immunol. 2020, 16, 39. [Google Scholar] [CrossRef]
- BSACI. Rhinitis 2017 Update; British Society for Allergy and Clinical Immunology: London, UK, 2017; Available online: https://www.bsaci.org/guidelines/bsaci-guidelines/rhinitis-2017-update/ (accessed on 22 January 2022).
- AAAAI, Hay Fever|Rhinitis Symptoms, Diagnosis, Management & Treatment; American Aacademy of Asthma Allergy and Iimmunology: Milwaukee, WI, USA, 2021; Available online: https://www.aaaai.org/Conditions-Treatments/Allergies/Hay-Fever-Rhinitis (accessed on 22 January 2022).
- Sheth, K. Evaluating the safety of intranasal steroids in the treatment of allergic rhinitis. Allergy Asthma Clin. Immunol. 2008, 4, 125–129. [Google Scholar] [CrossRef]
- Macias-Valle, L.; Psaltis, A.J. A Scholarly Review of the Safety and Efficacy of Intranasal Corticosteroids Preparations in the Treatment of Chronic Rhinosinusitis. Ear Nose Throat J. 2021, 100, 295–301. [Google Scholar] [CrossRef]
- Menditto, E.; Costa, E.; Midão, L.; Bosnic-Anticevich, S.; Novellino, E.; Bialek, S.; Briedis, V.; Mair, A.; Rajabian-Soderlund, R.; Arnavielhe, S.; et al. Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study. Clin. Exp. Allergy 2019, 49, 442–460. [Google Scholar] [CrossRef]
- Ocak, E.; Acar, B.; Kocaöz, D. Medical adherence to intranasal corticosteroids in adult patients. Braz. J. Otorhinolaryngol. 2017, 83, 558–562. [Google Scholar] [CrossRef]
- Rollema, C.; van Roon, E.N.; de Vries, T.W. Inadequate quality of administration of intranasal corticosteroid sprays. J. Asthma Allergy 2019, 12, 91–94. [Google Scholar] [CrossRef]
- Bridgeman, M.B. Overcoming barriers to intranasal corticosteroid use in patients with uncontrolled allergic rhinitis. Integr. Pharm. Res. Pr. 2017, 6, 109–119. [Google Scholar] [CrossRef]
- Rajasekaran, V.; Ghosh, P. Knowledge, attitude and practice about allergic rhinitis in a rural population, Kancheepuram district, Tamil Nadu. Int. J. Otorhinolaryngol. Head Neck Surg. 2018, 4, 159–162. [Google Scholar] [CrossRef]
- Manjit Singh, P.K.; Krishnan, E.K.; Mat Lazim, N.; Yaacob, N.M.; Abdullah, B. Medication Adherence to Intranasal Corticosteroids in Allergic Rhinitis Patients with Comorbid Medical Conditions. Pharmaceutics 2022, 14, 2459. [Google Scholar] [CrossRef] [PubMed]
- Fromer, L.M.; Ortiz, G.R.; Dowdee, A.M. Assessment of Patient Attitudes About Mometasone Furoate Nasal Spray: The Ease-of-Use Patient Survey. World Allergy Organ. J. 2008, 1, 156–159. [Google Scholar] [CrossRef]
- Katelaris, C.H.; Sacks, R.; Theron, P.N. Allergic rhinoconjunctivitis in the Australian population: Burden of disease and attitudes to intranasal corticosteroid treatment. Am. J. Rhinol. Allergy 2013, 27, 506–509. [Google Scholar] [CrossRef] [PubMed]
- Retinasekharan, S.; Md Shukri, N.; Ismail, A.F.; Abdullah, B. Knowledge, Attitude, and Practice of Intranasal Corticosteroid in Allergic Rhinitis Patients: Development of a New Questionnaire. Healthcare 2021, 10, 8. [Google Scholar] [CrossRef] [PubMed]
- Tsang, S.; Royse, C.F.; Terkawi, A.S. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J. Anaesth. 2017, 11, S80–S89. [Google Scholar] [CrossRef]
- Guillemin, F.; Bombardier, C.; Beaton, D. Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. J. Clin. Epidemiol. 1993, 46, 1417–1432. [Google Scholar] [CrossRef]
- Almehizia, A.A.; AlEssa, R.K.; Alwusaidi, K.M.; Alzamil, K.A.; AlJumah, M.; Aljohani, S.; Almutairi, A.F.; Salam, M. Allergic rhinitis: Disease characteristics and coping measures in Saudi Arabia. PLoS ONE 2019, 14, e0217182. [Google Scholar] [CrossRef]
- Awwad, O.; Akour, A.; Al-Muhaissen, S.; Morisky, D. The influence of patients’ knowledge on adherence to their chronic medications: A cross-sectional study in Jordan. Int. J. Clin. Pharm. 2015, 37, 504–510. [Google Scholar] [CrossRef]
- Almutairi, T.A.; Aldayel, A.A.; Aldayel, A.S.; Alotaibi, F.; Alhussain, H.A. Safety Concerns of Nasal Corticosteroids Usage in Patients With Allergic Rhinitis. Cureus 2020, 12, e11651. [Google Scholar] [CrossRef]
- Treat, S.; Ebert, C.S., Jr.; Farzal, Z.; Basu, S.; Zanation, A.M.; Thorp, B.D.; Kimbell, J.S.; Senior, B.A.; Kimple, A.J. Intranasal Corticosteroids: Patient Administration Angles and Impact of Education. Rhinol. Online 2020, 3, 160–166. [Google Scholar] [CrossRef] [PubMed]
- Cingi, C.; Songu, M. Nasal steroid perspective: Knowledge and attitudes. Eur. Arch. Otorhinolaryngol. 2010, 267, 725–730. [Google Scholar] [CrossRef] [PubMed]
- Gómez, R.M.; Croce, V.H.; Zernotti, M.E.; Muiño, J.C. Active smoking effect in allergic rhinitis. World Allergy Organ. J. 2021, 14, 100504. [Google Scholar] [CrossRef] [PubMed]
- Lee, S.E.; Brown, W.C.; Gelpi, M.W.; Kimple, A.J.; Senior, B.A.; Zanation, A.M.; Thorp, B.D.; Ebert, C.S., Jr. Understood? Evaluating the readability and understandability of intranasal corticosteroid delivery instructions. Int. Forum Allergy Rhinol. 2020, 10, 773–778. [Google Scholar] [CrossRef]
- Pogany, L.; Lazary, J. Health Control Beliefs and Attitude Toward Treatment in Psychiatric and Non-Psychiatric Clinical Samples. Front. Psychiatry 2021, 12, 537309. [Google Scholar] [CrossRef]
- Abdullah, B.; Kandiah, R.; Hassan, N.F.H.N.; Ismail, A.F.; Mohammad, Z.W.; Wang, D.Y. Assessment of perception, attitude, and practice of primary care practitioners towards allergic rhinitis practice guidelines: Development and validation of a new questionnaire. World Allergy Organ. J. 2020, 13, 100482. [Google Scholar] [CrossRef]
- Mohammed, I.A.; Shantier, S.W.; Elhag, E.A.; Osman, W. Assessment of knowledge, attitude, and practice of community pharmacists towards allergic rhinitis and its management in Khartoum state: A cross-sectional survey. Inform. Med. Unlocked 2022, 32, 101020. [Google Scholar] [CrossRef]
- Chalmers, G.W.; Macleod, K.J.; Little, S.A.; Thomson, L.J.; McSharry, C.P.; Thomson, N.C. Influence of cigarette smoking on inhaled corticosteroid treatment in mild asthma. Thorax 2002, 57, 226–230. [Google Scholar] [CrossRef]
Variables | Frequency | Proportion |
---|---|---|
Age (years): | ||
Less than 25 years | 135 | 33.8 |
25 to 40 years | 158 | 39.5 |
Above 40 years | 107 | 26.7 |
Gender: | ||
Male | 186 | 46.5 |
Female | 214 | 53.5 |
Marital status: | ||
Married | 232 | 58.0 |
Single | 137 | 34.3 |
Divorced/widowed | 31 | 7.7 |
Occupation: | ||
Government | 161 | 40.3 |
Private | 105 | 26.2 |
Self-employed/business | 64 | 16.0 |
Unemployed | 70 | 17.5 |
Education: | ||
Up to high school | 157 | 39.3 |
University level | 243 | 60.7 |
Income: | ||
Less than 5000 SAR | 94 | 23.5 |
5000 to 7000 SAR | 185 | 46.3 |
More than 7000 SAR | 121 | 30.2 |
Residence: | ||
City/urban | 315 | 78.8 |
Village/rural | 85 | 21.2 |
Smoking status: | ||
Yes | 83 | 20.7 |
No | 317 | 79.3 |
Allergic rhinitis status: | ||
Mild intermittent | 139 | 34.7 |
Mild regular | 111 | 27.8 |
Moderate to severe intermittent | 92 | 23.0 |
Moderate to severe permanent | 58 | 14.5 |
Where are you receiving treatment for your allergic rhinitis management? | ||
Specialist at hospital | 197 | 49.3 |
Primary health center | 135 | 33.7 |
Over the counter drugs at a pharmacy | 68 | 17.0 |
Duration of INCS usage | ||
Less than 1 year | 99 | 24.8 |
1 to 3 years | 162 | 40.5 |
More than 3 years | 139 | 34.7 |
Variables | Knowledge | Attitude | Practice | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Total | Poor and Average (n = 302) | Excellent (n = 98) | p-Value | Poor and Average (n = 274) | Excellent (n = 126) | p-Value | Poor and Average (n = 325) | Excellent (n = 75) | p-Value | |
Age (years): | 0.807 | 0.003 * | 0.952 | |||||||
Less than 25 years | 135 | 102 | 33 | 81 | 54 | 109 | 26 | |||
25 to 40 years | 158 | 117 | 41 | 107 | 51 | 128 | 30 | |||
Above 40 years | 107 | 83 | 24 | 86 | 21 | 88 | 19 | |||
Gender: | 0.287 | 0.908 | 0.910 | |||||||
Male | 186 | 145 | 41 | 130 | 59 | 154 | 35 | |||
Female | 214 | 157 | 57 | 144 | 67 | 171 | 40 | |||
Marital status: | 0.392 | 0.004 * | 0.029 * | |||||||
Married | 232 | 170 | 62 | 144 | 88 | 179 | 53 | |||
Single | 137 | 109 | 28 | 108 | 29 | 121 | 16 | |||
Divorced/widowed | 31 | 23 | 8 | 22 | 9 | 25 | 6 | |||
Occupation: | 0.004 * | 0.314 | 0.382 | |||||||
Government | 161 | 116 | 45 | 110 | 51 | 126 | 35 | |||
Private | 105 | 71 | 34 | 67 | 38 | 84 | 21 | |||
Self-employed/business | 64 | 53 | 11 | 43 | 21 | 54 | 10 | |||
Unemployed | 70 | 62 | 8 | 54 | 16 | 61 | 9 | |||
Education: | <0.001 * | 0.735 | 0.027 * | |||||||
Up to high school | 157 | 136 | 21 | 106 | 51 | 139 | 18 | |||
University level | 243 | 166 | 77 | 168 | 75 | 186 | 57 | |||
Income: | 0.098 | 0.043 * | 0.174 | |||||||
Less than 5000 SAR | 94 | 71 | 23 | 58 | 36 | 75 | 19 | |||
5000 to 7000 SAR | 185 | 139 | 46 | 123 | 62 | 151 | 34 | |||
More than 7000 SAR | 121 | 92 | 29 | 93 | 28 | 99 | 22 | |||
Residence: | 0.537 | 0.640 | 0.057 | |||||||
City/urban | 315 | 240 | 75 | 214 | 101 | 262 | 53 | |||
Village/rural | 85 | 62 | 23 | 60 | 25 | 63 | 22 | |||
Smoking status: | 0.006 * | 0.006 * | 0.038 * | |||||||
Yes | 83 | 72 | 11 | 67 | 16 | 74 | 9 | |||
No | 317 | 230 | 87 | 207 | 110 | 251 | 66 | |||
Allergic rhinitis status: | 0.113 | <0.001 * | 0.008 * | |||||||
Mild intermittent | 139 | 107 | 32 | 111 | 28 | 118 | 21 | |||
Mild regular | 111 | 84 | 27 | 80 | 31 | 95 | 16 | |||
Moderate to severe intermittent | 92 | 67 | 25 | 52 | 40 | 82 | 10 | |||
Moderate to severe permanent | 58 | 44 | 14 | 31 | 27 | 40 | 18 | |||
Follow up: | 0.036 * | 0.081 | 0.030 * | |||||||
Specialist at hospital | 197 | 148 | 49 | 134 | 63 | 156 | 41 | |||
Primary health center | 135 | 95 | 40 | 95 | 40 | 106 | 29 | |||
Over the counter drugs at pharmacy | 68 | 59 | 9 | 45 | 23 | 63 | 5 |
Spearman’s Correlation Value (rho) | p-Value | |
---|---|---|
Knowledge–attitude | 0.153 | 0.015 * |
Knowledge–practice | 0.451 | <0.001 * |
Attitude–practice | 0.297 | 0.003 * |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Al-Rasheedi, A.N. Knowledge of, Attitudes towards, and Practices of Intranasal Corticosteroids Usage among the Allergic Rhinitis Patients of Northern Saudi Arabia: A Cross-Sectional Study. Healthcare 2023, 11, 537. https://doi.org/10.3390/healthcare11040537
Al-Rasheedi AN. Knowledge of, Attitudes towards, and Practices of Intranasal Corticosteroids Usage among the Allergic Rhinitis Patients of Northern Saudi Arabia: A Cross-Sectional Study. Healthcare. 2023; 11(4):537. https://doi.org/10.3390/healthcare11040537
Chicago/Turabian StyleAl-Rasheedi, Abdullah N. 2023. "Knowledge of, Attitudes towards, and Practices of Intranasal Corticosteroids Usage among the Allergic Rhinitis Patients of Northern Saudi Arabia: A Cross-Sectional Study" Healthcare 11, no. 4: 537. https://doi.org/10.3390/healthcare11040537
APA StyleAl-Rasheedi, A. N. (2023). Knowledge of, Attitudes towards, and Practices of Intranasal Corticosteroids Usage among the Allergic Rhinitis Patients of Northern Saudi Arabia: A Cross-Sectional Study. Healthcare, 11(4), 537. https://doi.org/10.3390/healthcare11040537