Introduction:
Background: Various studies have proven the efficacy of steroid nasal spray in the treatment of inflammatory nasal conditions1,2. Currently, topical steroid nasal sprays are considered as the first-line treatment for the management of allergic rhinitis (hay fever) and chronic rhinosinusitis1,3,4,5. Intranasal steroids work locally inside the nose and are found to be more effective than systemic steroids2. Local application of steroids in the nose reduces systemic absorption, hence reducing systemic side effects6. Various steroid-based nasal sprays are available i.e. Beconase, Nasonex, Avamys, Flixonase 7. Combination nasal spray is also available which contains topical antihistamine and topical steroid i.e. Dymista 8.
Previous studies have investigated the correlation between spray technique and the distribution of drug inside the nose9,10,11,12. Correct spray technique and patient compliance are important factors for the nasal spray to work. Furthermore, incorrect spray technique can be associated with side effects i.e. irritation and epistaxis 6. Current guidance on the management of chronic rhinosinusitis, allergic and non-allergic rhinitis strongly recommends clinicians to check nasal spray technique and compliance 3,5.
Significant material is available on the internet for the patients on how to use the nasal spray but some of them are not as accurate7,13,14,15,16 . Therefore, we recommend following the written instructions for the use of steroid nasal spray from “British Society for Allergy and Clinical Immunology” or/and video tutorial from “ asthma.org.uk- how to use nasal spray” 7,13 (See below). We recommend following these steps when using steroid nose spray:
  1. Clear the nose.
  2. Slightly bend head forward.
  3. Use opposite hand when holding spray (Right hand for left nostril and left hand for right nostril).
  4. Direct spray inside the nose away from nasal septum (towards turbinate) towards ipsilateral ear or eye.
  5. Administer spray- avoid hard sniffing.
  6. Repeat the same for the other nostril.
Objectives: The main aims of this survey were:
  1. To investigate if patients use a correct spray technique while administering steroid nose spray.
  2. To investigate the patient’s compliance in using the steroid nose spray.