{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:05:53Z","timestamp":1789200353534,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The purpose of this study was to investigate real\u2010world adherence to intranasal corticosteroid irrigations using pharmacy data and assess factors associated with low adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing treatment with corticosteroid irrigations for any diagnosis during a 2\u2010year period were prospectively recruited. Subjects completed a one\u2010time set of questionnaires including the Barriers to Care Questionnaire (BCQ), 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022), and a questionnaire assessing their experience with corticosteroid irrigations. Pharmacy data was used to calculate the medication possession ratio (MPR), a measure of medication adherence graded from 0 to 1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010one patients were enrolled. Patient diagnoses included chronic rhinosinusitis (CRS) without nasal polyps (<jats:italic>n<\/jats:italic>\u00a0=\u00a037), CRS with nasal polyps (<jats:italic>n<\/jats:italic>\u00a0=\u00a024), or a non\u2010CRS diagnosis, most commonly chronic rhinitis (<jats:italic>n<\/jats:italic>\u00a0=\u00a010). The MPR for the overall group was 0.44\u00a0\u00b1\u00a00.33. Just 9.9% of patients had a perfect MPR of 1. Despite low MPR, only 19.7% of patients reported problems taking the medication when directly asked. Lower education resulted in lower MPR (unstandardized <jats:italic>B<\/jats:italic>\u00a0=\u00a00.065, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.046). Increasing BCQ score, indicating higher barriers to care, was associated with lower MPR (unstandardized <jats:italic>B<\/jats:italic>\u00a0=\u00a0\u22120.010, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.033). The lower the MPR, the worse the patient SNOT\u201022 scores (unstandardized <jats:italic>B<\/jats:italic>\u00a0=\u00a0\u221215.980, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adherence to corticosteroid irrigations was low and patients underreported issues with their medication. Education and barriers to care were associated with lower adherence, which, in turn, was associated with worse sinonasal quality of life.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.23210","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T14:21:35Z","timestamp":1686752495000},"page":"32-40","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Challenges to medication adherence with intranasal corticosteroid irrigations"],"prefix":"10.1002","volume":"14","author":[{"suffix":"III","given":"Jorge A.","family":"Gutierrez","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian M.","family":"Shannon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Chapurin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary M.","family":"Soler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Medical University of South Carolina Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ALR.22741"},{"issue":"260","key":"e_1_2_7_3_1","first-page":"1","article-title":"Summary health statistics for U.S. adults: national health interview survey, 2012","author":"Blackwell DL","year":"2014","journal-title":"Vital Health Stat 10"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24040"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318161e57b"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21581"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/chemse\/bjw061"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin20.600"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22093"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21172"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28152"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22034"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2011.12.022"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.19271"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra050100"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1367\/A03\u2010198R.1"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1749\u20134486.2009.01995.X"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2012.01.008"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.109\u20105705"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819886852"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24630"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22646"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882\u2010017\u20100690\u20105"},{"issue":"11","key":"e_1_2_7_24_1","first-page":"730","article-title":"The effects of prescription drug cost sharing: a review of the evidence","volume":"11","author":"Gibson TB","year":"2005","journal-title":"Am J Manag Care"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.17.1829"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010007\u20100180\u2010x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13\u20101705"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23191"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.22289"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10\u20101005"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl\u20102012\u2010303004"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/1945892421992659"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1230"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.23210","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T15:16:25Z","timestamp":1716390985000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.23210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,26]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/alr.23210"],"URL":"https:\/\/doi.org\/10.1002\/alr.23210","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"value":"2042-6976","type":"print"},{"value":"2042-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,26]]},"assertion":[{"value":"2023-04-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}