Related Experiment Video
Updated: Jan 23, 2026
Saline Lavage for Sampling of the Canine Nasal Immune Microenvironment
Published on: December 27, 2024
Intranasal corticosteroids and saline: Usage and adherence in chronic rhinosinusitis patients
Katie M Phillips1,2, Lloyd P Hoehle3, David S Caradonna1,4
1Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Objective:
Intranasal saline irrigations and intranasal corticosteroids are supported by level-1 evidence for medical management of chronic rhinosinusitis (CRS). We sought to study adherence with these medications.
Methods:
Prospective study of 174 patients with CRS. Patients reported their usage of intranasal saline irrigation and intranasal corticosteroid over the preceding 3 months, at presentation, and a subsequent follow-up visit 3 to 12 months later. Adherence was defined as reported medication usage for ≥6 days per week.
Results:
At the time of presentation, 44.3% of patients were using an intranasal corticosteroid spray or irrigation ≥6 days/week, whereas only 24.1% were using saline irrigation ≥6 days per week. At follow-up, 60.3% of patients were using either an intranasal corticosteroid spray or irrigation ≥6 days per week, whereas 35.6% were using saline irrigation ≥6 days per week. Adherence with intranasal corticosteroids was associated with comorbid asthma (adjusted odds ratio [OR] = 2.68, 95% confidence interval [CI]: 1.10-6.50, P = 0.029), allergy (OR = 2.22, 95% CI: 1.05-4.71, P = 0.037), and change in 22-item Sinonasal Outcome Test score (OR = 0.98, 95% CI: 0.96-0.99, P = 0.027). Use of intranasal corticosteroid sprays versus irrigations (OR = 2.56, 95% CI: 0.84-7.83, P = 0.099) was suggestive of association with improved adherence. Adherence with intranasal saline irrigation was associated with age (OR = 1.02, 95% CI: 1.01-1.05, P = 0.034).
Conclusion:
Usage and adherence with intranasal steroids and saline may be low in CRS patients even with management in a tertiary level, subspecialty rhinology clinic. Adherence with medications represents a major opportunity for improving patient care and outcomes, specifically by targeting patients with lower disease burden and improving convenience of medications.
Level Of Evidence:
2C Laryngoscope, 130:852-856, 2020.
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