过敏性鼻炎患者的用药依从性、感觉属性和鼻内皮质类固醇的不良反应:系统回顾和荟萃分析。

IF 2.3 4区 医学 Q3 ALLERGY
Baharudin Abdullah, Farah Dayana Zahedi, Aneeza Hamizan, Salina Husain
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引用次数: 0

摘要

背景:鼻内皮质类固醇(INCS)仍然是治疗过敏性鼻炎(AR)的主要方法。了解用药依从性、安全问题和感官偏好对优化治疗至关重要:本综述旨在确定过敏性鼻炎患者的用药依从性、INCS 的感官特性和不良反应:方法:对 PubMed、Web of Science、Scopus 和 Cochrane 数据库中 2004 年至 2023 年发表的英文文章进行系统检索。研究对象包括接受 INCS 治疗 AR(间歇性和持续性)的成年患者(18 岁或以上)的临床试验和观察性研究:共纳入 31 项研究,10,582 名患者,包括 10 项横断面研究和 21 项随机对照试验 (RCT)。依从率从 28% 到 87% 不等,平均依从率为 55.8%。遗忘是不坚持用药的主要原因(63.1%-77.8%),其次是不良反应(26.4%-61.5%)和对不良反应的恐惧(3.8%-31.5%)。气味(38%)、味道(28.5%)或余味(24.3%)是感官属性的主要区分因素,每个 INCS 的强度和偏好程度各不相同。常见的不良反应包括鼻衄、鼻腔干燥/刺激、头痛和鼻咽炎。对 8 项临床试验进行的荟萃分析发现,INCS 组和对照组在不良反应方面没有显著差异(风险比 1.05;95% 置信区间 0.88-1.24;P = 0.61):本综述的结果表明,INCS 的用药依从性并不理想,不依从的主要原因是健忘、对感官属性的偏好以及与 INCS 相关的不良反应。作为提高依从性的多模式策略的一部分,应解决这些潜在因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medication adherence, sensory attributes, and adverse effects of intranasal corticosteroids in allergic rhinitis patients: A systematic review and meta-analysis.

Background: Intranasal corticosteroid (INCS) remains the primary treatment for allergic rhinitis (AR). Understanding adherence, safety concerns and sensory preferences is crucial for optimal care.

Objective: This review aims to determine medication adherence, sensory attributes and adverse effects of INCS in AR patients.

Methods: A systematic search of PubMed, Web of Science, Scopus, and Cochrane database was conducted for English articles published from 2004 to 2023. Eligibility includes clinical trials and observational studies with adult patients (18 years old or older) receiving INCS for AR (both intermittent and persistent).

Results: Thirty-one studies with 10,582 patients, comprising 10 cross-sectional studies and 21 randomized controlled trials (RCT) were included. Adherence rates ranged from 28% to 87%, with an average of 55.8%. Forgetfulness was the primary reason for non-adherence (63.1-77.8%), followed by adverse events (26.4-61.5%) and fear of adverse events (3.8-31.5%). Scent (38%), taste (28.5%), or aftertaste (24.3%) were the main differentiators for sensory attribute, with varying levels of intensity and preferences for each INCS. Common adverse events encompass epistaxis, nasal dryness/irritation, headache and nasopharyngitis. A meta-analysis of eight RCT detected no significant difference in adverse events between the INCS and control groups (risk ratio 1.05; 95% confidence interval, 0.88-1.24; p = 0.61).

Conclusions: The findings of this review indicate that medication adherence to INCS is not optimal, with non-adherence mostly attributed to forgetfulness, preferences for sensory attributes, and unpleasant effects associated with INCS. The underlying factors should be addressed as part of a multimodal strategy to improve adherence.

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来源期刊
CiteScore
12.80
自引率
0.00%
发文量
74
审稿时长
>12 weeks
期刊介绍: The Asian Pacific Journal of Allergy and Immunology (APJAI) is an online open access journal with the recent impact factor (2018) 1.747 APJAI published 4 times per annum (March, June, September, December). Four issues constitute one volume. APJAI publishes original research articles of basic science, clinical science and reviews on various aspects of allergy and immunology. This journal is an official journal of and published by the Allergy, Asthma and Immunology Association, Thailand. The scopes include mechanism, pathogenesis, host-pathogen interaction, host-environment interaction, allergic diseases, immune-mediated diseases, epidemiology, diagnosis, treatment and prevention, immunotherapy, and vaccine. All papers are published in English and are refereed to international standards.
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