Intranasal corticosteroid users in The Netherlands: A drug utilization study

Abstract

BackgroundTo improve (patient-tailored) instructions for intranasal corticosteroid (INC) administration we need to gain insight into specific characteristics of INC-users and co-medication use. ObjectiveWe examined INC drug prescriptions, obtained from the Dutch InterAction Database, to get insight into the prevalence- and incidence rates, INC-use in previous years and co-medication. MethodsWe retrospectively examined INC prescriptions between January 1, 2015, and December 31, 2019. Prevalence- and incidence rates were stratified by age and gender. The use of INCs in previous years and co-medication were analyzed. ResultsThe total number of INC prescriptions in 2019 was 172,563, dispensed to 75,048 individuals. The prevalence and incidence of INC users were 68.9 and 25.6 per 1,000 individuals respectively in 2019. INCs were used by all age-groups. More than half of the users in 2019 did not receive a prescription in 2018, almost a quarter received a prescription in five consecutive years. 28% of the users used an INC in combination with an inhaler, 29% with a systemic antihistamine, 9% with ocular medication and 1% with an intranasal antihistamine. Several corticosteroids-containing drugs are used in combination with INCs by 2 to 16%. ConclusionThis study gives insights into opportunities for patient-tailored instructions. INCs are used by various age groups and by new or intermittent users and continuous users. Based on this, patient-tailored instructions can be developed and then it needs to be studied if these instructions affect treatment adherence and efficacy. The insights gained about co-medication provide opportunities for improved evaluation of the INC administration technique. Altogether, these suggestions might lead to a more patient-tailored approach which might lead to improved treatment with intranasal corticosteroids.