Challenges to medication adherence with intranasal corticosteroid irrigations

Area of Science:

• Otolaryngology
• Rhinology
• Pharmacology

Background:

• Intranasal corticosteroid irrigations are commonly prescribed for sinonasal conditions.
• Real-world adherence to these treatments can be suboptimal.
• Understanding adherence patterns is crucial for optimizing patient outcomes.

Purpose of the Study:

• To investigate real-world adherence to intranasal corticosteroid irrigations.
• To identify factors associated with low medication adherence.
• To assess the impact of adherence on sinonasal quality of life.

Main Methods:

• Prospective recruitment of patients using corticosteroid irrigations over 2 years.
• Assessment of medication adherence using pharmacy data (medication possession ratio, MPR).
• Collection of patient-reported data via questionnaires (Barriers to Care Questionnaire, Sino-Nasal Outcome Test-22).

Main Results:

• The overall medication possession ratio (MPR) was 0.44 ± 0.33, with only 9.9% of patients achieving perfect adherence.
• Lower educational attainment and higher reported barriers to care were significantly associated with lower MPR.
• Lower adherence (MPR) correlated with worse Sino-Nasal Outcome Test-22 scores, indicating poorer sinonasal quality of life.

Conclusions:

• Adherence to intranasal corticosteroid irrigations is notably low in real-world settings.
• Patients frequently underreport difficulties with their prescribed medication.
• Educational attainment and barriers to care are key factors influencing adherence, which directly impacts patient-reported outcomes.