Insights on allergic rhinitis from the patient perspective
FIGURE 4
Patient perceptions of nasal steroid medications: (A) good things they have heard or (B) bad things they have heard
Patients who were familiar with intranasal steroid sprays were asked:
(A) What good things, if any, have you heard about these drugs?
(B) What bad things, if any, have you heard about these drugs?
Base: Familiar with intranasal steroid sprays, unweighted, n = 288.
Patients who had used a prescription intranasal steroid spray for their nasal allergies in the past, but not in the past 4 weeks, were asked why they had not recently used their intranasal steroid spray. Most commonly, past users of prescription nasal sprays said that they had no symptoms (20%) or the symptoms were not bad enough (17%). Other reasons for not using within the past 4 weeks included lack of effectiveness (12%), side effects (9%), poor tolerability (2%), and concerns about dependence (2%). A similar proportion of past users said they had not used prescription nasal sprays in the past 4 weeks because they did not like sprays (8%) or the delivery mechanism (5%). Finally 8% of AR patients reported that they had not used prescription nasal sprays in the past 4 weeks because of barriers to care (no insurance coverage, 3%; cost or co-pay too expensive, 3%; no access to a provider, 2%) (FIGURE 5).
FIGURE 5
Patient reasons for not using nasal steroids in the past 4 weeks
Patients who no longer use an intranasal steroid spray were asked:
Why haven't you used a prescription intranasal steroid spray for your nasal allergies in the past 4 weeks?
Base: No longer use an intranasal steroid spray, unweighted, n = 158.
The survey showed that patient satisfaction with prescription intranasal steroid sprays varies with their experience with side effects. The majority of patients (72%) who have ever used prescription intranasal steroid sprays for their allergies said that, in general, they had been somewhat satisfied or very satisfied with their prescription steroid nasal spray, whereas 19% reported they were somewhat dissatisfied or very dissatisfied. There was a statistically significant difference in satisfaction between those who feel the medication drip down the throat sometimes or more often (81%) and those who rarely or never did (96%) (P < 0.05, FIGURE 6A) and an even more dramatic and statistically significant difference in the satisfaction with their intranasal steroid sprays between those who felt any discomfort from these sprays at least sometimes (66%) and those who rarely or never felt discomfort from the sprays (92%) (P < 0.05, FIGURE 6B).
FIGURE 6
Patient satisfaction with intranasal steroid sprays, based on frequency of side-effect experiences: (A) feeling the medication drip down the throat and (B) feeling discomfort from the spray
Patients who had used intranasal steroid spray within the past year were asked: When you use your intranasal steroid spray, how often do you (A) feel the medication drip down the throat or (B) feel any discomfort from the spray: always, most of the time, sometimes, rarely, or never? Patients were also asked: In general, how satisfied were you with the prescription intranasal steroid spray you used for your nasal allergies in the past?
Base: Used intranasal steroid spray in the past year, unweighted, n = 171;
*Pearson chi-square, P = 0.05.
Reasons for Using a Particular Intranasal Steroid Spray
Nearly 1 in 10 patients who have used intranasal steroid sprays (8%) said that they had asked their HCP to prescribe a particular intranasal steroid spray (FIGURE 7A). Of these, 40% said they wanted it because they believed it was more effective, 25% said that they did so because of previous experience with that product, 11% said that the product requested was easier to administer, and 11% said that the product they requested had less smell. Only 4% of those who requested a specific intranasal steroid spray said that they did so because it was covered by their insurance or because of an advertisement.
On the other side of the table, HCPs were asked how often their patients asked them to prescribe a particular intranasal steroid spray. A number of allergists and otolaryngologists reported that they were asked to prescribe a particular intranasal spray at least daily (14% and 18%, respectively), a few days a week (20% and 14%), or at least once a week (16% and 18%). Substantially fewer PCPs (6%) and NP/PAs (6%) reported requests for specific intranasal steroid sprays on a daily basis. But nearly 2 in 5 PCPs (39%) and NP/PAs (38%) said that patients asked them to prescribe a particular intranasal spray at least once a week (FIGURE 7B).
