Conclusion:
Wrong spray technique is extremely common among patients using the steroid nose spray. This is something which currently seems to be overlooked by many clinicians, which is easily correctable. Moreover, patient compliance can be further improved. We emphasize the importance of giving verbal as well as written instructions to the patients when prescribing steroid nose spray.
Conflicts of Interest : None declared
Data availability statement : The data that support the findings of this study are available from the corresponding author upon reasonable request.
Funding: No funding.
References:
  1. Penagos M, Compalati E, Tarantini F, Baena-Cagnani C, Passalacqua G, Canonica GW. Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta-analysis of randomized, double-blind, placebo-controlled, clinical trials. Allergy 2008 10/01; 2020/08;63(10):1280-1291.
  2. Rodrigo G, Neffen H. Efficacy of fluticasone furoate nasal spray vs. placebo for the treatment of ocular and nasal symptoms of allergic rhinitis: a systematic review. Clinical & Experimental Allergy 2011;41(2):160-170.
  3. Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology 2020;58(Supplement 29):1-464.
  4. Allergic Rhinitis. 2018; Available at: https://cks.nice.org.uk/topics/allergic-rhinitis/. Accessed 08/01, 2020.
  5. Scadding GK, Kariyawasam HH, Scadding G, Mirakian R, Buckley RJ, Dixon T, et al. BSACI guideline for the diagnosis and management of allergic and non‐allergic rhinitis (Revised Edition 2017; 2007). Clinical & Experimental Allergy 2017;47(7):856-889.
  6. Ganesh V, Banigo A, McMurran A, Shakeel M, Ram B. Does intranasal steroid spray technique affect side effects and compliance? Results of a patient survey. The Journal of Laryngology & Otology 2017;131(11):991-996.
  7. Topical Nasal Corticosteroid Spray. 2017; Available at: https://www.bsaci.org/wp-content/uploads/2019/12/Howtouseanasalspray.pdf. Accessed 08/01, 2020.
  8. Dymista. 2020; Available at: https://www.dymista.co.uk/en-gb/dymista-allergy-nasal-spray. Accessed 08/01, 2020.
  9. Merkus P, Ebbens FA, Muller B, Fokkens WJ. The ’best method’ of topical nasal drug delivery: comparison of seven techniques. Rhinology 2006 Jun;44(2):102-107.
  10. Bateman N, Whymark A, Clifton N, Woolford T. A study of intranasal distribution of azelastine hydrochloride aqueous nasal spray with different spray techniques. Clinical Otolaryngology & Allied Sciences 2002;27(5):327-330.
  11. Tsikoudas A, Homer J. The delivery of topical nasal sprays and drops to the middle meatus: a semiquantitative analysis. Clinical Otolaryngology & Allied Sciences 2001;26(4):294-297.
  12. Aggarwal R, Cardozo A, Homer J. The assessment of topical nasal drug distribution. Clinical Otolaryngology & Allied Sciences 2004;29(3):201-205.
  13. How to use nasal spray. 2020; Available at: https://www.asthma.org.uk/advice/inhaler-videos/nasal-spray/. Accessed 08/01, 2020.
  14. Nasal Sprays: How to Use Them Correctly. 2000; Available at: https://www.aafp.org/afp/2000/1215/p2695.html. Accessed 08/01, 2020.
  15. Nasal Sprays: How to Use Them Correctly. 2017; Available at: https://familydoctor.org/nasal-sprays-how-to-use-them-correctly/. Accessed 08/01, 2020.
  16. HOW TO GET COMFORTABLE WITH NASAL SPRAYS (YOUR NOSE WILL THANK YOU!). 2018; Available at: https://www.flonase.com/allergies/how-to-use-nasal-spray/. Accessed 08/01, 2020.
  17. Nasal Sprays: How to Use Them Correctly. 2017; Available at: https://familydoctor.org/nasal-sprays-how-to-use-them-correctly/. Accessed 08/01, 2020.
  18. Nabi S, Rotenberg BW, Vukin I, Payton K, Bureau Y. Nasal Spray Adherence after Sinus Surgery: Problems and Predictors. Journal of Otolaryngology–Head & Neck Surgery 2012;41.
  19. Baddar S, Jayakrishnan B, Al-Rawas OA. Asthma control: importance of compliance and inhaler technique assessments. Journal of asthma 2014;51(4):429-434.
  20. Hamdan A, Ahmed A, Abdullah A, Khan M, Baharoon S, Salih SB, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy, asthma & clinical immunology 2013;9(1):8.
  21. Kebede B, Mamo G, Molla A. Association of Asthma Control and Metered-Dose Inhaler Use Technique among Adult Asthmatic Patients Attending Outpatient Clinic, in Resource-Limited Country: A Prospective Study. Canadian respiratory journal 2019;2019.