title: Self-medication in persistent rhinitis: overuse of decongestants in half of the patients.
abstract: BACKGROUND
  Patients with rhinitis often self-medicate with over-the-counter drugs, however this self-treating population has remained largely unstudied.
  
  
  OBJECTIVE
  To characterize individuals self-medicating persistent rhinitis and to determine the prevalence of and risk factors for intranasal decongestant overuse within this population.
  
  
  METHODS
  A cross-sectional observational study of individuals self-medicating persistent rhinitis (defined according to the Allergic Rhinitis and its Impact on Asthma guidelines). Participants (n = 895) completed a self-administered questionnaire to assess current symptoms, rhinitis medication, and previous physician diagnosis. Intranasal decongestant overuse was defined as daily use for at least 1 year.
  
  
  RESULTS
  The vast majority of subjects (95%) had moderate-to-severe rhinitis. Nasal congestion was the predominant symptom (median visual analog scale, 6.6 cm; interquartile range, 3.4 cm). Sixty-five percent had had their current nasal problems for more than 5 years. Approximately 80% had a physician diagnosis (mainly allergic rhinitis or rhinosinusitis). The prevalence of intranasal decongestant overuse was high (49%), despite the fact that most of the patients (80%) were educated about the limit on duration of use. Use of intranasal glucocorticosteroids was inversely related to being an overuser (odds ratio 0.24 [95% CI, 0.17-0.35]). The risk of intranasal decongestant overuse also was reduced by use of other medications (oral H1 antihistamines and decongestants), use of nasal saline solution, and more symptoms of itchy and/or runny eyes or colored mucus. Risk was increased by a more severely blocked nose, longer duration of symptoms, the presence of sleep disturbance, higher body mass index, and previous advice to limit the duration of intranasal decongestant use.
  
  
  CONCLUSIONS
  Half of the individuals self-medicating persistent rhinitis overused intranasal decongestants, despite the fact that they were educated about the limit on duration of use.
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium. Electronic address: els.mehuys@ugent.be.
authors.forename: Els
authors.initials: E
authors.lastname: Mehuys
authors.affiliation: Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gevaert
authors.affiliation: Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Brusselle
authors.affiliation: Department of Clinical Pharmacy, University of Liège, Avenue de l'Hôpital 1, Liège, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Van Hees
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Adriaens
authors.affiliation: Department of Family Medicine and Primary Health Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Christiaens
authors.affiliation: Heymans Institute of Pharmacology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Van Bortel
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Inge
authors.initials: I
authors.lastname: Van Tongelen
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Remon
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Boussery
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001530:Belgium; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014663:Nasal Decongestants / Q000008:administration & dosage / Q000627:therapeutic use*; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D012220:Rhinitis / Q000188:drug therapy*; D012651:Self Medication / Q000379:methods* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D014663:Nasal Decongestants; D004366:Nonprescription Drugs
keywords: Community pharmacy; Rhinitis; Self-medication