Table 4.
Physician Treatment Decision Factors and Attitudes Towards INCSs, Overall and by Country
| All (N=1637) | Brazil (n=212) | Mexico (n=201) | SA (n=200) | UAE (n=200) | Japan (n=218) | Korea (n=206) | Spain (n=200) | UK (n=200) | |
|---|---|---|---|---|---|---|---|---|---|
| Symptoms influencing choice of INCS prescription medications,a n (%) | |||||||||
| Watery or runny nose | 1036 (9.9) | 136 (64.2) | 116 (57.7) | 127 (63.5) | 133 (66.5) | 133 (61.0) | 116 (56.3) | 137 (68.5) | 138 (69.0) |
| Repeated sneezingb | 962 (9.2) | 152 (71.7) | 91 (45.3) | 145 (72.5) | 118 (59.0) | 115 (52.8) | 122 (59.2) | 92 (46.0) | 127 (63.5) |
| Frequent itchy nose or nasal itchingb | 991 (9.5) | 151 (71.2) | 116 (57.7) | 122 (61.0) | 116 (58.0) | 99 (45.4) | 133 (64.6) | 116 (58.0) | 138 (69.0) |
| Nasal congestion and/or obstruction | 1324 (12.6) | 162 (76.4) | 180 (89.6) | 142 (71.0) | 163 (81.5) | 155 (71.1) | 171 (83.0) | 187 (93.5) | 164 (82.0) |
| Frequent watery eyes or itchy eyesb | 678 (6.5) | 122 (57.5) | 81 (40.3) | 78 (39.0) | 98 (49.0) | 60 (27.5) | 92 (44.7) | 63 (31.5) | 84 (42.0) |
| Red eyesb | 433 (4.1) | 87 (41.0) | 39 (19.4) | 79 (39.5) | 67 (33.5) | 34 (15.6) | 50 (24.3) | 34 (17.0) | 46 (23.0) |
| Throat itchingb | 490 (4.7) | 96 (45.3) | 59 (29.4) | 67 (33.5) | 68 (34.0) | 43 (19.7) | 49 (23.8) | 40 (20.0) | 68 (34.0) |
| Headacheb | 427 (4.1) | 72 (34.0) | 64 (31.8) | 86 (43.0) | 60 (30.0) | 30 (13.8) | 27 (13.1) | 52 (26.0) | 36 (18.0) |
| Reduced sense of smellb | 745 (7.1) | 100 (47.2) | 118 (58.7) | 80 (40.0) | 111 (55.5) | 64 (29.4) | 60 (29.1) | 114 (57.0) | 98 (49.0) |
| Post-nasal dripb | 744 (7.1) | 121 (57.1) | 94 (46.8) | 62 (31.0) | 113 (56.5) | 47 (21.6) | 75 (36.4) | 102 (51.0) | 130 (65.0) |
| Interference with sleepc | 947 (9.0) | 126 (59.4) | 128 (63.7) | 102 (51.0) | 133 (66.5) | 111 (50.9) | 112 (54.4) | 111 (55.5) | 124 (62.0) |
| Impairment of daily activitiesb | 907 (8.7) | 122 (57.5) | 126 (62.7) | 92 (46.0) | 126 (63.0) | 104 (47.7) | 103 (50.0) | 120 (60.0) | 114 (57.0) |
| Impairment of work or schoolb | 783 (7.5) | 106 (50.0) | 101 (50.2) | 72 (36.0) | 117 (58.5) | 92 (42.2) | 88 (42.7) | 100 (50.0) | 107 (53.5) |
| Otherc | 12 (0.1) | 0 | 1 (0.5) | 0 | 0 | 3 (1.4) | 1 (0.5) | 1 (0.5) | 6 (3.0) |
| Preferred treatment for mild AR, n (%) | |||||||||
| Only OAHs | 1006 (61.5) | 96 (45.3) | 148 (73.6) | 122 (61.0) | 120 (60.0) | 149 (68.3) | 137 (66.5) | 112 (56.0) | 122 (61.0) |
| Only intranasal antihistamines | 157 (9.6) | 30 (14.2) | 8 (4.0) | 19 (9.5) | 14 (7.0) | 23 (10.6) | 12 (5.8) | 29 (14.5) | 22 (11.0) |
| Only INCSs | 261 (15.9) | 48 (22.6) | 24 (11.9) | 15 (7.5) | 40 (20.0) | 23 (10.6) | 28 (13.6) | 43 (21.5) | 40 (20.0) |
| Only anti-leukotrienes | 71 (4.3) | 8 (3.8) | 8 (4.0) | 4 (2.0) | 4 (2.0) | 18 (8.3) | 24 (11.7) | 3 (1.5) | 2 (1.0) |
| INCSs and OAHs | 95 (5.8) | 10 (4.7) | 12 (6.0) | 37 (18.5) | 16 (8.0) | 2 (0.9) | 3 (1.5) | 5 (2.5) | 10 (5.0) |
| INCSs and intranasal antihistamines | 31 (1.9) | 15 (7.1) | 0 | 2 (1.0) | 2 (1.0) | 2 (0.9) | 1 (0.5) | 6 (3.0) | 3 (1.5) |
| Other | 16 (1.0) | 5 (2.4) | 1 (0.5) | 1 (0.5) | 4 (2.0) | 1 (0.5) | 1 (0.5) | 2 (1.0) | 1 (0.5) |
| Preferred treatment for moderate AR, n (%) | |||||||||
| Only OAHs | 111 (6.8) | 5 (2.4) | 4 (2.0) | 18 (9.0) | 13 (6.5) | 39 (17.9) | 20 (9.7) | 10 (5.0) | 2 (1.0) |
| Only intranasal antihistamines | 63 (3.9) | 6 (2.8) | 7 (3.5) | 11 (5.5) | 12 (6.0) | 7 (3.2) | 6 (2.9) | 4 (2.0) | 10 (5.0) |
| Only INCSs | 230 (14.1) | 31 (14.6) | 34 (16.9) | 18 (9.0) | 27 (13.5) | 26 (11.9) | 25 (12.1) | 26 (13.0) | 43 (21.5) |
| Only anti-leukotrienes | 54 (3.3) | 8 (3.8) | 12 (6.0) | 2 (1.0) | 5 (2.5) | 11 (5.0) | 9 (4.4) | 5 (2.5) | 2 (1.0) |
| INCSs and OAHs | 983 (60.2) | 119 (56.1) | 125 (62.2) | 134 (67.0) | 128 (64.0) | 108 (49.5) | 122 (59.2) | 133 (66.5) | 114 (57.0) |
| INCSs and intranasal antihistamines | 171 (10.5) | 39 (18.4) | 16 (8.0) | 16 (8.0) | 8 (4.0) | 22 (10.1) | 20 (9.7) | 22 (11.0) | 28 (14.0) |
| Other | 22 (1.3) | 4 (1.9) | 3 (1.5) | 1 (0.5) | 7 (3.5) | 5 (2.3) | 4 (1.9) | 0 | 1 (0.5) |
| Preferred treatment for severe AR, n (%) | |||||||||
| Only OAHs | 15 (0.9) | 1 (0.5) | 0 | 3 (1.5) | 0 | 7 (3.2) | 3 (1.5) | 1 (0.5) | 0 |
| Only intranasal antihistamines | 6 (0.4) | 3 (1.4) | 0 | 2 (1.0) | 0 | 1 (0.5) | 0 | 0 | 0 |
| Only INCSs | 36 (2.2) | 4 (1.9) | 5 (2.5) | 7 (3.5) | 13 (6.5) | 1 (0.5) | 2 (1.0) | 2 (1.0) | 2 (1.0) |
| Only anti-leukotrienes | 37 (2.3) | 8 (3.8) | 4 (2.0) | 5 (2.5) | 9 (4.5) | 3 (1.4) | 3 (1.5) | 5 (2.5) | 0 |
| INCSs and OAHs | 933 (57.0) | 108 (50.9) | 111 (55.2) | 115 (57.5) | 123 (61.5) | 118 (54.1) | 122 (59.2) | 139 (69.5) | 97 (48.5) |
| INCSs and intranasal antihistamines | 504 (30.8) | 63 (29.7) | 70 (34.8) | 65 (32.5) | 36 (18.0) | 76 (34.9) | 66 (32.0) | 46 (23.0) | 82 (41.0) |
| Other | 106 (6.5) | 25 (11.8) | 11 (5.5) | 3 (1.5) | 19 (9.5) | 12 (5.5) | 10 (4.9) | 7 (3.5) | 19 (9.5) |
| Preferred treatment for seasonal allergies, n (%) | |||||||||
| Only OAHs | 683 (41.7) | 83 (39.2) | 107 (53.2) | 68 (34.0) | 85 (42.5) | 91 (41.7) | 86 (41.7) | 87 (43.5) | 76 (38.0) |
| Only intranasal antihistamines | 120 (7.3) | 42 (19.8) | 18 (9.0) | 8 (4.0) | 4 (2.0) | 10 (4.6) | 8 (3.9) | 12 (6.0) | 18 (9.0) |
| Only INCSs | 188 (11.5) | 35 (16.5) | 19 (9.5) | 25 (12.5) | 35 (17.5) | 17 (7.8) | 24 (11.7) | 14 (7.0) | 19 (9.5) |
| Only anti-leukotrienes | 66 (4.0) | 5 (2.4) | 11 (5.5) | 4 (2.0) | 6 (3.0) | 14 (6.4) | 18 (8.7) | 4 (2.0) | 4 (2.0) |
| INCSs and OAHs | 481 (29.4) | 29 (13.7) | 41 (20.4) | 84 (42.0) | 66 (33.0) | 70 (32.1) | 62 (30.1) | 73 (36.5) | 56 (28.0) |
| INCSs and intranasal antihistamines | 87 (5.3) | 17 (8.0) | 4 (2.0) | 11 (5.5) | 1 (0.5) | 15 (6.9) | 6 (2.9) | 8 (4.0) | 25 (12.5) |
| Other | 12 (0.7) | 1 (0.5) | 1 (0.5) | 0 | 3 (1.5) | 1 (0.5) | 2 (1.0) | 2 (1.0) | 2 (1.0) |
| Preferred treatment for perennial allergies, n (%) | |||||||||
| Only OAHs | 253 (15.5) | 8 (3.8) | 14 (7.0) | 11 (5.5) | 17 (8.5) | 79 (36.2) | 67 (32.5) | 31 (15.5) | 26 (13.0) |
| Only intranasal antihistamines | 93 (5.7) | 18 (8.5) | 12 (6.0) | 11 (5.5) | 8 (4.0) | 11 (5.0) | 6 (2.9) | 11 (5.5) | 16 (8.0) |
| Only INCSs | 245 (15.0) | 43 (20.3) | 35 (17.4) | 19 (9.5) | 32 (16.0) | 17 (7.8) | 29 (14.1) | 35 (17.5) | 35 (17.5) |
| Only anti-leukotrienes | 125 (7.6) | 14 (6.6) | 27 (13.4) | 12 (6.0) | 16 (8.0) | 15 (6.9) | 19 (9.2) | 16 (8.0) | 6 (3.0) |
| INCSs and OAHs | 737 (45.0) | 96 (45.3) | 89 (44.3) | 125 (62.5) | 113 (56.5) | 76 (34.9) | 73 (35.4) | 83 (41.5) | 82 (41.0) |
| INCSs and intranasal antihistamines | 164 (10.0) | 30 (14.2) | 22 (10.9) | 21 (10.5) | 8 (4.0) | 18 (8.3) | 10 (4.9) | 23 (11.5) | 32 (16.0) |
| Other | 20 (1.2) | 3 (1.4) | 2 (1.0) | 1 (0.5) | 6 (3.0) | 2 (0.9) | 2 (1.0) | 1 (0.5) | 3 (1.5) |
| Preferred treatment for both seasonal and perennial allergies, n (%) | |||||||||
| Only OAHs | 108 (6.6) | 3 (1.4) | 4 (2.0) | 3 (1.5) | 7 (3.5) | 37 (17.0) | 24 (11.7) | 16 (8.0) | 14 (7.0) |
| Only intranasal antihistamines | 15 (0.9) | 3 (1.4) | 0 | 1 (0.5) | 1 (0.5) | 3 (1.4) | 3 (1.5) | 1 (0.5) | 3 (1.5) |
| Only INCSs | 77 (4.7) | 11 (5.2) | 15 (7.5) | 10 (5.0) | 11 (5.5) | 6 (2.8) | 8 (3.9) | 11 (5.5) | 5 (2.5) |
| Only anti-leukotrienes | 59 (3.6) | 6 (2.8) | 12 (6.0) | 5 (2.5) | 9 (4.5) | 10 (4.6) | 11 (5.3) | 5 (2.5) | 1 (0.5) |
| INCSs and OAHs | 978 (60.1) | 122 (57.5) | 121 (60.2) | 117 (58.5) | 133 (66.5) | 113 (51.8) | 119 (57.8) | 136 (68.0) | 117 (58.5) |
| INCSs and intranasal antihistamines | 360 (22.1) | 59 (27.8) | 44 (21.9) | 61 (30.5) | 28 (14.0) | 46 (21.1) | 38 (18.4) | 29 (14.5) | 55 (27.5) |
| Other | 30 (1.8) | 8 (3.8) | 5 (2.5) | 3 (1.5) | 11 (5.5) | 3 (1.4) | 3 (1.5) | 2 (1.0) | 5 (2.5) |
| INCS does not need to be used every day to be effective year-round, n (%) | |||||||||
| Strongly agree | 349 (21.3) | 36 (17.0) | 44 (21.9) | 84 (42.0) | 48 (24.0) | 24 (11.0) | 49 (23.8) | 47 (23.5) | 17 (8.5) |
| Somewhat agree | 677 (41.4) | 87 (41.0) | 82 (40.8) | 57 (28.5) | 61 (30.5) | 114 (52.3) | 105 (51.0) | 87 (43.5) | 84 (42.0) |
| Somewhat disagree | 384 (23.5) | 56 (26.4) | 39 (19.4) | 22 (11.0) | 41 (20.5) | 68 (31.2) | 46 (22.3) | 46 (23.0) | 66 (33.0) |
| Strongly disagree | 227 (13.9) | 33 (15.6) | 36 (17.9) | 37 (18.5) | 50 (25.0) | 12 (5.5) | 6 (2.9) | 20 (10.0) | 33 (16.5) |
| INCSs have a good safety profile, n (%) | |||||||||
| Strongly agree | 753 (46.0) | 128 (60.4) | 117 (58.2) | 121 (60.5) | 93 (46.5) | 39 (17.9) | 65 (31.6) | 104 (52.0) | 86 (43.0) |
| Somewhat agree | 754 (46.1) | 72 (34.0) | 76 (37.8) | 56 (28.0) | 84 (42.0) | 144 (66.1) | 126 (61.2) | 91 (45.5) | 105 (52.5) |
| Somewhat disagree | 113 (6.9) | 10 (4.7) | 6 (3.0) | 17 (8.5) | 17 (8.5) | 34 (15.6) | 15 (7.3) | 5 (2.5) | 9 (4.5) |
| Strongly disagree | 17 (1.0) | 2 (0.9) | 2 (1.0) | 6 (3.0) | 6 (3.0) | 1 (0.5) | 0 | 0 | 0 |
| INCSs should be delayed for children until they are adults, n (%) | |||||||||
| Strongly agree | 154 (9.4) | 18 (8.5) | 11 (5.5) | 57 (28.5) | 29 (14.5) | 14 (6.4) | 7 (3.4) | 8 (4.0) | 10 (5.0) |
| Somewhat agree | 408 (24.9) | 58 (27.4) | 43 (21.4) | 49 (24.5) | 32 (16.0) | 79 (36.2) | 42 (20.4) | 63 (31.5) | 42 (21.0) |
| Somewhat disagree | 512 (31.3) | 54 (25.5) | 50 (24.9) | 30 (15.0) | 55 (27.5) | 91 (41.7) | 87 (42.2) | 58 (29.0) | 87 (43.5) |
| Strongly disagree | 563 (34.4) | 82 (38.7) | 97 (48.3) | 64 (32.0) | 84 (42.0) | 34 (15.6) | 70 (34.0) | 71 (35.5) | 61 (30.5) |
| The route of administration influences patient adherence,b n (%) | |||||||||
| Strongly agree | 745 (45.5) | 99 (46.7) | 112 (55.7) | 116 (58.0) | 112 (56.0) | 38 (17.4) | 81 (39.3) | 109 (54.5) | 78 (39.0) |
| Somewhat agree | 755 (46.1) | 102 (48.1) | 66 (32.8) | 65 (32.5) | 70 (35.0) | 148 (67.9) | 115 (55.8) | 80 (40.0) | 109 (54.5) |
| Somewhat disagree | 125 (7.6) | 11 (5.2) | 18 (9.0) | 17 (8.5) | 16 (8.0) | 30 (13.8) | 10 (4.9) | 11 (5.5) | 12 (6.0) |
| Strongly disagree | 12 (0.7) | 0 | 5 (2.5) | 2 (1.0) | 2 (1.0) | 2 (0.9) | 0 | 0 | 1 (0.5) |
Notes: All values shown are percentages for evaluable participant responses (not all physicians surveyed responded to every question). aN=10,389 (physicians could have multiple answers). bp<0.001 (Chi-squared test). cp<0.05 (Chi-squared test).
Abbreviations: AR, Allergic rhinitis; INCS, intranasal corticosteroid; OAH, oral antihistamines; SA, Saudi Arabia; UAE, United Arab Emirates; UK, United Kingdom.