Awareness and Practices among Patients with Allergic Rhinitis Receiving Intranasal Corticosteroid Spray at National Referral Hospital, Bhutan: A Cross Sectional Study

Abstract

Introduction: Allergic rhinitis is one of the most common diseases being presented to the Ear, Nose, and Throat (ENT) Outpatient Department (OPD), affecting approximately 500 million people globally. The disease is associated with a substantial socioeconomic burden due to impaired quality of life, reduced work and school productivity and escalating healthcare costs. Intranasal corticosteroid sprays are well established as the most effective first-line treatment for patients with allergic rhinitis.  Inadequate knowledge and improper use of intranasal corticosteroids may result in suboptimal therapeutic outcomes. The present study aims to evaluate the level of awareness and practices among patients with allergic rhinitis receiving intranasal 
corticosteroid therapy at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Bhutan. Methods: A cross-sectional study was conducted at the ENT OPD, JDWNRH from July 2022 to January 2023. Patients with allergic rhinitis were included in the study using a systematic random sampling, and data was collected using a standard validated questionnaire and analysed using Stata.  Results: 201 patients were recruited for the study. 71% (n=142) had poor awareness regarding allergic rhinitis and its treatment. 55% (n=111) had poor practices, while only 43% (n=86) could demonstrate the correct technique of nasal spray application. Education level had a significant association with awareness and practices among patients with allergic rhinitis (aOR 2.74, 95% CI 1.34 – 3.75, p-value =0.001). Conclusion: Poor awareness and suboptimal practices were observed among patients with allergic rhinitis using intranasal corticosteroid at JDWNRH, which may potentially contribute to inadequate disease control.