PRESCRIPTION PATTERNS AND PATIENT ACCEPTANCE OF INTRANASAL CORTICOSTEROIDS IN SEASONAL ALLERGIC RHINITIS: A CROSS-SECTIONAL STUDY IN AN URBAN POPULATION

Abstract

Background: Seasonal allergic rhinitis (SAR) is a prevalent immunoglobulin E–mediated inflammatory condition of the nasal mucosa, characterized by sneezing, nasal congestion, rhinorrhea, and itching. Intranasal corticosteroids (INCS) are the mainstay of pharmacotherapy due to their superior efficacy and safety profile. However, real-world adherence to prescribed INCS therapy remains suboptimal, particularly in urban populations, where socio-cultural perceptions, health literacy, and physician-patient interactions may influence treatment acceptance. Aim and Objectives: To evaluate the prescription patterns of steroid nasal sprays among patients diagnosed with SAR in urban clinical settings and to identify the factors influencing their acceptance and continued use. Materials: A cross-sectional observational study was conducted over six months in ENT and general outpatient departments of urban tertiary care hospitals. Patients aged 18–60 years diagnosed with SAR and prescribed INCS were enrolled after informed consent. A structured questionnaire captured demographic data, prescription details, patient-reported adherence, and perception-based factors influencing usage. Descriptive statistics, chi-square tests, and logistic regression were applied to identify significant determinants of acceptance and adherence. Results: Among 300 SAR patients enrolled, 212 (70.6%) were prescribed INCS as first-line therapy. Fluticasone and Mometasone were the most commonly prescribed agents. Only 148 patients (69.8%) adhered to therapy beyond two weeks. Key reasons for non-adherence included fear of dependency (34.1%), perceived lack of immediate relief (27.8%), cost concerns (15.2%), and lack of counselling (22.9%). Acceptance was significantly associated with higher education (p<0.01), previous use of INCS (p<0.05), and detailed physician explanation at the time of prescription (p<0.001). Logistic regression revealed that physician counselling and prior awareness of SAR significantly predicted continued INCS use (Adjusted OR: 3.45; 95% CI: 1.92–6.18). Conclusion: Despite being clinically recommended, the real-world acceptance of INCS in urban SAR patients is hampered by misperceptions, inadequate counselling, and affordability issues. Strengthening patient education, reinforcing the safety profile of INCS, and incorporating behavioural support strategies into prescription practices may improve treatment adherence and clinical outcomes.