Exploring Adherence to Treatment in Nasal Polyposis

Valverde‐Monge, Marcela; Barroso, Blanca; Ortega-Martín, L; Betancor, Diana; Santillan, J; Villacampa, J M; Sastre, Juan Antonio López

doi:10.18176/jiaci.0752

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…This emphasizes the need to instruct patients on the proper application technique, which is routinely performed by roughly half of the participants in this survey. This is relevant since side effects may also reduce compliance to therapy [ 18 , 19 ]. Moreover, the correct use of topical steroids guarantees higher efficacy of the drug, which reaches the nasal polyps instead of the nasal septum or pharynx.…”

Section: Discussionmentioning

confidence: 99%

Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs

Corso

Pipolo²,

Cantone

et al. 2022

JPM

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Background: Local and systemic corticosteroids have long been the workhorse in management of chronic rhinosinusitis with nasal polyps (CRSwNP), although there is no universally accepted modality of prescription. We carried out a survey in Italy to capture current trends in the use of topical and systemic corticosteroids in patients with CRSwNP. Methods: A survey was set up on Survey Monkey®. Each author distributed the link to the survey in an ad hoc manner and a total of 437 participants filled out the survey. Results: Mometasone furoate (79.3%) was the most frequently prescribed, administered daily by 61.9% of participants; the remaining preferred to discontinue treatment for brief periods to reduce side effects or to modulate the therapy in mild cases. The majority believe that a short cycle of systemic steroids should be prescribed for re-exacerbation of symptoms and that the number of cycles in the previous year should be evaluated to define control of the disease even if international guidelines do not provide clear indications on this topic. A certain degree of divergence emerged from responses regarding how long and the maximal dose of systemic steroids which place patients at high risk for adverse events. Finally, systemic corticosteroids seem to offer only temporary benefit on recovery of smell without guaranteeing long-term control even if the patient is adherent to topical corticosteroids. Conclusions: Our results highlight the need for clear guidelines on oral steroids, which could help supporting the use of a precision medicine approach, including indications for new biological agents.

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Section: Discussionmentioning

confidence: 99%

Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs

Corso

Pipolo²,

Cantone

et al. 2022

JPM

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“…Our results showed that INCS (88.3%) and oral antihistamines (51.8%) were the most prescribed drugs in CRSwNP patients. However, poor compliance of INCS has been previously reported in these patients (57) .…”

Section: Moreover Crs Patients Commonly Suffer From Coexisting T2mentioning

confidence: 72%

Prevalence of chronic rhinosinusitis without/with nasal polyps according to severity in Spain

Mullol,

Sastre,

Domínguez-Ortega

et al. 2024

Rhin

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Background: The worldwide prevalence range of chronic rhinosinusitis (CRS) is 5-12%; from this, 20 % have nasal polyps. Due to the little epidemiological data about CRS in the Spanish population, this study analyses the prevalence and severity of CRS with (CRSwNP) or without (CRSsNP) nasal polyps, and their connection with other coexisting type 2 inflammatory diseases in Spain. Methodology: This is a retrospective, large-scale, nationwide, epidemiological study based on the electronic medical records from the BIG-PAC® database. Patients diagnosed of CRSsNP and CRSwNP were identified using specific disease codes. The severe form of the disease was defined as patients who received at least a long course of antibiotics in CRSsNP or ≥2 short courses of systemic corticosteroids in CRSwNP in ≤12 months during the last 2 years, and/or had previous sinus surgery. Physician-diagnosed prevalence, sociodemographic and clinical characteristics, and disease severity were assessed. Results: Out of a cohort of 1,012,257 patients (≥18 years old), 42,863 and 7,550 patients with diagnosed CRSsNP and CRSwNP, respectively, were analysed. The overall prevalence of diagnosed CRS was 5.1%, being 4.3% and 0.8% for CRSsNP and CRSwNP, respectively. Patients with CRSwNP and severe forms of the disease were older and had higher levels of type 2 inflammatory biomarkers than CRSsNP patients and non-severe disease. Conclusions: Although CRSsNP was more prevalent than CRSwNP, the severe forms of CRS were more frequent in patients with CRSwNP. In addition, CRSwNP patients had a higher incidence of coexisting type 2 inflammatory diseases.

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Predicting Adherence to Topical Medications in Chronic Rhinologic Disease: A Systematic Review

Monos,

Yan,

McLean

2024

Otolaryngol.--head neck surg.

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ObjectiveTo determine risk factors of medical adherence and describe strategies to increase adherence in patients with chronic rhinologic disease.Data SourcesPubMED, SCOPUS, CINAHL, and Cochrane.Review MethodsSystematic review of 4 databases (PubMED, SCOPUS, CINAHL, Cochrane) from inception of databases to September 1, 2022 to identify studies that evaluated factors related to and affected by medical adherence in patients with chronic rhinologic disease.ResultsOf 1491 studies screened, 25 studies met inclusion criteria. Of these, 7 studies described how sensory attributes of intranasal sprays affect adherence, including odor, taste, aftertaste, and side effects. Five studies described record keeping diaries/notification systems to improve adherence, with demonstration of web‐based platforms to send reminders as well as keep record of medication usage to improve adherence. Eight studies described patient‐specific risk factors to nonadherence, with demonstration of increased age and conscientious personalities correlating with medical adherence. Five studies looked at pediatric patients specifically, with adherence rates in children parallelling that of adults. Additionally, nonadherence in children may have greater implications for school performance.ConclusionOverall, adherence to topical medical therapy in patients with chronic rhinologic disease is affected by patient‐related and medication‐specific factors which should be considered when counseling patients. Web‐based diary or notification systems may help increase adherence. Additionally, children are equally adherent to topical medical therapy as adults and nonadherence may have negative implications for school performance.

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Exploring Adherence to Treatment in Nasal Polyposis

Abstract: Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory respiratory disorder with a significant deleterious impact on quality of life. Intranasal corticosteroids (INCS) and saline irrigation are the mainstay treatment [1].

Cited by 4 publications

References 6 publications

Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs

Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs

Prevalence of chronic rhinosinusitis without/with nasal polyps according to severity in Spain

Predicting Adherence to Topical Medications in Chronic Rhinologic Disease: A Systematic Review

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