From relief to reliance: unveiling patients' opinions on nasal decongestant overuse

Published: December 02, 2022

Nasal congestion is a common symptom that can be caused by various conditions such as allergies, sinusitis, and nasal polyps. It can have a negative impact on sleep, quality of life, and productivity. The treatment for nasal congestion depends on the underlying cause, but also on patient preferences. Nasal decongestants are commonly used, but long-term use can lead to a condition called rhinitis medicamentosa, characterized by rebound congestion when the medication wears off. Previous research indicated that many patients are aware about the limited duration of use, but patients continue to use it despite being advised otherwise.

In a recent publication in The Journal of Allergy and Clinical Immunology: In Practice, Scheire and colleagues interviewed patients who had been using nasal decongestants for an extended period of time (range: 2-40 years). The study aimed to unravel the reasons for long-term use and barriers to discontinue the use of the medication.

Participants in this study considered the nasal decongestant indispensable because they believed it was the only effective way to relieve their nasal congestion. Their blocked noses greatly impacted their daily lives, and patients felt anxious or physically unwell when they didn't have the nasal decongestant with them. Despite being aware of the potential harms of long-term use, participants continued to use the medication and some even concealed its use from their healthcare professionals or loved ones. Barriers to discontinuation included anxiety about the impact on sleep, negative experiences with past withdrawal attempts, lack of knowledge about rhinitis medicamentosa, and the perceived lack of effective alternatives. However, there was also a strong desire among participants to discontinue the medication due to concerns about long-term effects. Taken together, patients face a dilemma where the obstacles to withdrawing the nasal decongestant outweigh the potential benefits. The findings of this study emphasize that interventions to reduce rhinitis medicamentosa should focus on addressing the barriers to withdrawal, along with the provision of knowledge and adequate support to facilitate discontinuation of the medication.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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