Aqueous beclomethasone dipropionate nasal spray in the treatment of seasonal (ragweed) rhinitis.

OBJECTIVES: To determine whether the provision of appropriate medication and comprehensive information before the ragweed pollen season enables patients to manage their hay fever successfully, achieving satisfactory symptom control and quality of life, to examine patient characteristics that may predict successful symptom management and to learn which factors patients consider when making treatment choices. DESIGN: Single-group prospective cohort management study. SUBJECTS: Ninety adults sensitive to ragweed pollen recruited from those who had participated in previous clinical studies and from those who responded to advertisements in the local media. INTERVENTION: Aqueous beclomethasone dipropionate nasal spray and comprehensive information about optimal therapy (starting before the ragweed pollen season and continued throughout at a dose of 400 micrograms/d) and how it may be used less intensively with an as-required regimen. MAIN OUTCOME MEASURES: Symptom control, patient satisfaction, quality of life and medication use. RESULTS: More than 80% of the patients reported very good symptom control and were very satisfied. In all, 62% chose to use less than the optimal daily dose. Patients who had less than optimal symptom control used significantly less of the nasal spray than those with very good control either because they wanted to keep medication use to a minimum or because they were unable to remember to take their medication. The only significant predictor of inadequate control was an acknowledged inability to remember to take medication. Symptoms and trust in the practitioner were the primary factors perceived by the patients to determine their treatment choices. CONCLUSION: When provided with aqueous beclomethasone dipropionate nasal spray and comprehensive information on the drug and dosing, most patients are successful in managing their hay fever.