Patient preferences for sensory attributes of intranasal corticosteroids and willingness to adhere to prescribed therapy for allergic rhinitis: a conjoint analysis.
ABSTRACT Sensory attributes of intranasal corticosteroid (INS) products vary.
To evaluate patient preferences for INS sensory attributes and the degree to which attributes influence patients' willingness to adhere to therapy.
We conducted a cross-sectional study with 120 individuals across 4 US allergy/immunology clinics. Respondents chose between pairs of hypothetical INSs differing in sensory attribute composition. We measured the strength of preferences for 6 sensory attributes (smell, taste, aftertaste, throat rundown, nose runout, and feel of spray in nose or throat). Preferences were measured for 3 intensity levels of each sensory attribute (eg, no taste, weak taste, and strong taste). Other outcomes included an importance score for each sensory attribute and patients' willingness to adhere to therapy with an INS with the lowest intensity levels of each sensory attribute vs one with moderate intensity levels.
Preferences decreased with increasing intensity levels of each sensory attribute. Aftertaste was the most important attribute in 28% of patients, taste in 19%, throat rundown in 18%, nose runout in 12%, smell in 11%, and feel of spray in 7%. If instructed to take an INS daily for 3 months, 77% of patients stated that they would definitely be able to follow their physician's advice (willingness to adhere) if given one containing the lowest level of each sensory attribute vs 4% if given one having moderate levels (P < .01).
Patient preferences are inversely related to increasing intensity levels of sensory attributes and affect patients' willingness to adhere to therapy. Application of patient preferences when selecting INSs could improve adherence.
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ABSTRACT: Allergic rhinitis (AR) is a disease with a significant global burden, associated with many comorbidities and quality-of-life issues. Overwhelming evidence shows that intranasal corticosteroids are the most effective treatment for AR to control the disease, decrease comorbidities, and decrease costs. Poor adherence is a major barrier to achieving control of AR. This article addresses patient preferences and satisfaction regarding intranasal corticosteroids and factors leading to better adherence. We review and summarize the published literature. Factors affecting patient preference and, ultimately, adherence include a variety of sensory components such as odor, taste, comfort of delivery, delivery devices (aerosol versus aqueous) and patient cost. The intensity of adverse sensory attributes is negatively correlated with patient preference and the likelihood of adherence. Selection of an intranasal steroid (INS) with patient preference and satisfaction in mind can influence patient outcomes and cost. Providers need to assess each patient to determine which inhaled INS will lead to the best adherence, thereby improving outcomes in our patients and ultimately reducing the overall global burden of this disease.Allergy and Asthma Proceedings 01/2014; 35(1):24-33. · 3.35 Impact Factor
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ABSTRACT: Sensory attributes of intranasal corticosteroids, such as rundown to the back of the throat, may influence patient treatment preferences. This study compares the nasal deposition and nasal retention of a radiolabeled solution of ciclesonide nasal aerosol (CIC-hydrofluoroalkane [HFA]) with a radiolabeled suspension of mometasone furoate monohydrate aqueous nasal spray (MFNS) in subjects with either perennial allergic rhinitis (AR) or seasonal AR. In this open-label, single-dose, randomized, crossover scintigraphy study, 14 subjects with symptomatic AR received a single dose of radiolabeled 74 micrograms CIC-HFA (37 micrograms/spray, 1 spray/each nostril) via a nasal metered-dose inhaler or a single dose of radiolabeled 200 micrograms MFNS (50 micrograms/spray, 2 sprays/each nostril), with a minimum 5-day washout period between treatments. Initial deposition (2 minutes postdose) of radiolabeled CIC-HFA and MFNS in the nasal cavity, nasopharynx, and on nasal wipes, and retention of radioactivity in the nasal cavity and nasal run-out on nasal wipes at 2, 4, 6, 8, and 10 minutes postdose were quantified with scintigraphy. At 2 and 10 minutes postdose, deposition of radiolabeled CIC-HFA was significantly higher in the nasal cavity versus radiolabeled MFNS (99.42% versus 86.50% at 2 minutes, p = 0.0046; and 81.10% versus 54.31% at 10 minutes, p = 0.0001, respectively; p values unadjusted for multiplicity). Deposition of radioactivity on nasal wipes was significantly higher with MFNS versus CIC-HFA at all five time points, and posterior losses of radiolabeled formulation were significantly higher with MFNS at 6, 8, and 10 minutes postdose. In this scintigraphic study, significantly higher nasal deposition and retention of radiolabeled aerosol CIC-HFA were observed versus radiolabeled aqueous MFNS in subjects with AR.American Journal of Rhinology and Allergy 02/2014;
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