title: Nasal saline irrigation in preschool children: a survey of attitudes and prescribing habits of primary care pediatricians working in northern Italy.
abstract: BACKGROUND
  It has been shown that nasal saline irrigation (NSI) alone can be effective in children with infectious and/or allergic respiratory problems, but no study has assessed the awareness or clinical use of NSI among practising pediatricians. The main aim of this study was to evaluate the use of NSI in pre-school children by primary care pediatricians working in northern Italy.
  
  
  METHODS
  Nine hundred randomly selected National Health Service primary care pediatricians with an e-mail address were sent an e-mail asking whether they were willing to respond to a questionnaire regarding the use of NSI. The 870 who answered positively were sent an anonymous questionnaire by post and e-mail that had 17 multiple-choice items.
  
  
  RESULTS
  Completed questionnaires were received from 860 of the 870 primary care pediatricians (98.8%). NSI was used by almost all the respondents (99.3%), although with significant differences in frequency. It was considered both a prophylactic and a therapeutic measure by most of the respondents (60.3%), who prescribed it every day for healthy children and more frequently when they were ill. Most of the primary care pediatricians (87%) indicated an isotonic solution as the preferred solution, and the most frequently recommended administration devices were a nasal spray (67.7%) and bulb syringe (20.6%). Most of the pediatricians (75.6%) convinced parents to use NSI by explaining it could have various beneficial effects, and two-thirds (527/854; 61.7%) thought that most of the parents agreed about the importance of NSI. Analysis of possible associations between NSI prescribing behaviour and the demographic data revealed an associations with age and gender, with pediatricians aged <50 years prescribing NSI more frequently than their older counterparts (p < 0.01), and females prescribing NSI more frequently than males (p < 0.01).
  
  
  CONCLUSIONS
  In Northern Italy, most primary care pediatricians prescribe NSI for both the prophylaxis and therapy of upper respiratory tract problems in pre-school children. However, many aspects of the procedure are not clarified, and this reduces parental compliance. Given the medical and economic advantages of NSI, this situation should be changed as soon as possible.
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122 Milano, Italy. paola.marchisio@unimi.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Marchisio
authors.forename: Marina
authors.initials: M
authors.lastname: Picca
authors.forename: Sara
authors.initials: S
authors.lastname: Torretta
authors.forename: Elena
authors.initials: E
authors.lastname: Baggi
authors.forename: Angela
authors.initials: A
authors.lastname: Pasinato
authors.forename: Sonia
authors.initials: S
authors.lastname: Bianchini
authors.forename: Erica
authors.initials: E
authors.lastname: Nazzari
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.forename: Nicola
authors.initials: N
authors.lastname: Principi
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D058007:Physicians, Primary Care / Q000523:psychology* / Q000592:standards; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation; D055815:Young Adult
chemical_list: D012965:Sodium Chloride