Publication: A study of allergic rhinitis patients’ adherence to intranasal corticosteroid spray in Hospital Kuala Lumpur
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Date
2022
Authors
Singh, Prempreet Kaur Manjit
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Abstract
Introduction: Allergic rhinitis (AR) is characterized by the inflammatory changes in the nasal cavity mucosa caused by inhaled allergens. The prevalence of allergic rhinitis ranges from 2.3%-7.1% among Asia-Pacific countries. Adequate medication adherence is known as taking 80% or more of the medication prescribed. Objective: This study was conducted to determine factors influencing the adherence to intranasal corticosteroid spray among AR patients attending the ORL clinic in a tertiary Hospital Kuala Lumpur involving 185 participants. Method: This was a cross-sectional study and data was collected using a self-administered questionnaire. Simple and Multiple Logistic Regression analysis was conducted to determine factors for compliance. Ethical approval was obtained from Medical Research and Ethic Committee of National Medical Research Registry (NMRR). Results: Response rate of this study was 93% with 185 participants. Age of participants ranged from 18 to 74 years, with females (59.5%) being the majority. Prevalence of clinical adherence to INCS among AR patients in this study was 58.9%. There was significant association between serum IgE level [X2 (1) = 8.371, p=0.004], DP type of dust mite [X2 (1) = 5.149, p=0.023], severity of total nasal symptom score (TNSS) during the first visit [X2 (2) = 37.016, p=0.001] and second visit [X2 (2) = 10.304, p=0.006]. Besides, it was found that significant risk factors for clinical adherence to INCS were participants with DP type of dust mite allergy (OR:2.13, p<0.001), participants who had elevated IgE (OR:2.69, p<0.004) and participants with severe TNSS during the first visit to ORL clinic (OR:15.13, p<0.001). It was found that male participants were 2.481 times more likely to be clinically adherent to INCS compared to females (AOR:2.481, 95% CI:1.140-5.397). Non-malay participants were 3.683 times more likely to be clinically adherent to INCS compared to Malays (AOR:3.683, 95% CI:1.546-8.774). Whereas, participants with severe TNSS (AOR:33.570, 95% CI:7.595-148.385) were 34 times more likely to be clinically adherent to INCS. Married participants were 2.6 times more likely to be clinically adherent to INCS (AOR:2.553, 95% CI: 1.152-5.660). Conclusion: This study showed DP house dust mite, higher IgE due to allergy which affected participants quality of life which was depicted via TNSS participants adhered more to INCS. Even though patient factor also influenced adherence level, nevertheless the role of awareness and continuous patient education in the health facilities also will play an important role for the benefit of AR patients quality of life of this country.
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Keywords
allergic rhinitis , clinical adherence