Intranasal corticosteroid users in The Netherlands: A drug utilization study

TL;DR

This study examines how intranasal corticosteroids are used in the Netherlands, focusing on user characteristics and medication combinations to improve patient instructions.

Contribution

The study provides new insights into the demographics and medication patterns of intranasal corticosteroid users in the Netherlands.

Findings

In 2019, 75,048 individuals received at least one intranasal corticosteroid prescription in the Netherlands.

Over half of users were new or intermittent users, while a quarter used the medication continuously for five years.

Common combinations included inhalers, systemic antihistamines, and ocular medications.

Abstract

To improve (patient-tailored) instructions for intranasal corticosteroid (INC) administration, we need to gain insight into specific characteristics of INC users and comedication use.

We examined INC prescriptions obtained from the Dutch InterAction Database to gain insight into the prevalence and incidence rates, INC use in previous years, and comedication.

We retrospectively examined INC prescriptions written between January 1, 2015, and December 31, 2019. Prevalence and incidence rates were stratified by age and sex. The use of INCs in previous years and comedication were analyzed.

In 2019, a total of 172,563 INC prescriptions were written and dispensed to 75,048 individuals. Also in 2019, the prevalence and incidence of INC users were 68.9 and 25.6 per 1000 individuals, respectively. INCs were used by all age groups. More than half of INC users in 2019 did not receive a prescription in 2018, almost a quarter received a prescription in 5 consecutive years, 28% used an INC in combination with an inhaler, 29% used an INC together with a systemic antihistamine, 9% used an INC along with ocular medication, and 1% used an INC with an intranasal antihistamine. Several corticosteroid-containing drugs were being used in combination with INCs by 2% to 16% of those studied.

This study gives insights into opportunities for patient-tailored instructions. INCs are used by various age groups and by new or intermittent users as well as by continuous users. On the bases of these results, patient-tailored instructions can be developed and subsequently studied to determine whether the instructions affect treatment adherence and efficacy. The insights gained about comedication provide opportunities for improved evaluation of the INC administration technique. Taken together, these suggestions might lead to a more patient-tailored approach, which might in turn lead to improved treatment with INCs.

Figures