References of "Van Hees, Thierry"
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See detailAdverse Health Events Related to Self-Medication Practices Among Elderly: A Systematic Review.
Locquet, Médéa ULg; Honvo, Germain ULg; Rabenda, Véronique ULg et al

in Drugs & Aging (2017)

BACKGROUND: Older adults often resort to self-medication to relieve symptoms of their current illnesses; however, the risks of this practice are multiplied in old age. In particular, this age group is ... [more ▼]

BACKGROUND: Older adults often resort to self-medication to relieve symptoms of their current illnesses; however, the risks of this practice are multiplied in old age. In particular, this age group is more vulnerable to adverse drug events because of the physiological changes that occur due to senescence. OBJECTIVE: The aim of the study was to obtain an overview of the adverse health events related to self-medication among subjects aged 60 years and over through a systematic review of the literature. METHODS: A study of relevant articles was conducted among databases (MEDLINE, PsycINFO, and EBM Reviews-Cochrane Database of Systematic Reviews). Eligibility criteria were established and applied by two investigators to include suitable studies. The results and outcomes of interest were detailed in a descriptive report. RESULTS: The electronic search identified 4096 references, and the full texts of 74 were reviewed, of which four were retained in the analysis: three had a cross-sectional design and one prospectively followed elderly subjects. The first study showed a 26.7% prevalence of adverse drug reactions (ADRs) among elders, the second study found a 75% prevalence of side effects, and, finally, a prospective study showed an ADR incidence of 4.5% among self-medicated elders. These studies showed that adverse health events related to self-medication are relatively frequently reported. They also highlighted that analgesics and anti-inflammatory drugs are the most self-medicated products, while vitamins and dietary supplements also appear to be frequently self-administered, but by older individuals. CONCLUSIONS: Studies on self-medication in the elderly and its adverse health effects are clearly lacking. There is a need to perform prospective studies on this topic to gain a clear understanding of the extent of this problem and to enhance the awareness of health professionals to better inform seniors. [less ▲]

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See detailRevue de la médication par le pharmacien d'officine en Belgique : pourquoi, comment et situation actuelle
Tommelein, E; Mehuys, E; Van Tongelen, I et al

in Journal de Pharmacie de Belgique (2016), 4

Des statistiques récentes montrent qu’environ 20% de la population de l’Union européenne a plus de 65 ans. En raison de la multimorbidité (présence de plusieurs affections chroniques chez un même patient ... [more ▼]

Des statistiques récentes montrent qu’environ 20% de la population de l’Union européenne a plus de 65 ans. En raison de la multimorbidité (présence de plusieurs affections chroniques chez un même patient), plusieurs médicaments (polymérisation) sont souvent prescrits aux personnes âgées. Tant l’âge avance que la polymérisation augmente considérablement le risque d’effets indésirables. Des études internationales montrent qu’environ 5% de toutes les hospitalisations aigues sont liées a l’utilisation d’un médicament. Près de 70% de ces hospitalisations liées aux médicaments concernent des patients âgés de plus de 65 ans et près de la moitie de ces hospitalisations auraient pu être évitées. Ces hospitalisations évitables sont dues a la prise de médicaments sans indication, a des problèmes d’observance thérapeutique, a des interactions médicamenteuses et/ou a un manque de suivi. Il s’agit la de ce qu’on appelle des Problèmes (potentiellement) Lies aux Médicaments (P(p)LM). Les PLM peuvent se produire à différents moments du processus de gestion des médicaments : la prescription, la délivrance, l’utilisation et le suivi. Bon nombre de conséquences sévères des PLM pourraient être évitées par la détection précoce de ceux-ci. Plusieurs stratégies sont possibles pour dépister a temps les PLM et y remédier. Une de ces possibilités est d’effectuer périodiquement une revue de la médication auprès des groupes de patients les plus vulnérables. La revue de la médication consiste à évaluer les informations médicales, pharmaceutiques et d’utilisation de la pharmacothérapie de manière structurée et critique. La mise en œuvre de la revue de la médication en première ligne est actuellement encore limitée. Le pharmacien d’officine est pourtant, en tant que prestataire de soins pharmaceutiques, idéalement place pour assurer cette tache. Il existe une véritable relation de confiance entre le patient et son pharmacien ; l’accessibilité et la fréquence des contacts entre le patient et le pharmacien d’officine sont également des avantages. En outre, ce dernier dispose aussi d’une vue d’ensemble complète des médicaments utilisés par le patient et, en tant qu’expert des médicaments, il a les connaissances nécessaires pour effectuer l’analyse de la pharmacothérapie. [less ▲]

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See detailDetailed analysis of sputum and systemic inflammation in asthma phenotypes: are paucigranulocytic asthmatics really non-inflammatory?
Demarche, Sophie ULg; SCHLEICH, FLorence ULg; HENKET, Monique ULg et al

in BMC Pulmonary Medicine (2016), 16

BACKGROUND: The technique of induced sputum has allowed to subdivide asthma patients into inflammatory phenotypes according to their level of granulocyte airway infiltration. There are very few studies ... [more ▼]

BACKGROUND: The technique of induced sputum has allowed to subdivide asthma patients into inflammatory phenotypes according to their level of granulocyte airway infiltration. There are very few studies which looked at detailed sputum and blood cell counts in a large cohort of asthmatics divided into inflammatory phenotypes. The purpose of this study was to analyze sputum cell counts, blood leukocytes and systemic inflammatory markers in these phenotypes, and investigate how those groups compared with healthy subjects. METHODS: We conducted a retrospective cross-sectional study on 833 asthmatics recruited from the University Asthma Clinic of Liege and compared them with 194 healthy subjects. Asthmatics were classified into inflammatory phenotypes. RESULTS: The total non-squamous cell count per gram of sputum was greater in mixed granulocytic and neutrophilic phenotypes as compared to eosinophilic, paucigranulocytic asthma and healthy subjects (p < 0.005). Sputum eosinophils (in absolute values and percentages) were increased in all asthma phenotypes including paucigranulocytic asthma, compared to healthy subjects (p < 0.005). Eosinophilic asthma showed higher absolute sputum neutrophil and lymphocyte counts than healthy subjects (p < 0.005), while neutrophilic asthmatics had a particularly low number of sputum macrophages and epithelial cells. All asthma phenotypes showed an increased blood leukocyte count compared to healthy subjects (p < 0.005), with paucigranulocytic asthmatics having also increased absolute blood eosinophils compared to healthy subjects (p < 0.005). Neutrophilic asthma had raised CRP and fibrinogen while eosinophilic asthma only showed raised fibrinogen compared to healthy subjects (p < 0.005). CONCLUSIONS: This study demonstrates that a significant eosinophilic inflammation is present across all categories of asthma, and that paucigranulocytic asthma may be seen as a low grade inflammatory disease. [less ▲]

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See detailThe use of antibiotics in the university hospitals of Conakry: evaluation of the consumption and the analysis of determinants
Keita, Mory; Traore, Falaye; Camara, Mohamed Elmahady et al

in International Journal of Community Medicine and Public Health (2016), 3(6), 1547-1553

Background: The main objectives of this study were to evaluate the use of antibiotics; assess the knowledge and perception of prescribers regarding the use of antibiotics; to describe the policy on the ... [more ▼]

Background: The main objectives of this study were to evaluate the use of antibiotics; assess the knowledge and perception of prescribers regarding the use of antibiotics; to describe the policy on the use of antibiotics and to identify factors associated with high antibiotic consumption at the University Hospital of Conakry. Methods: This study has two components: a retrospective study covering three months' consumption of antibiotics (From January 2013 to March 2013), and a cross-sectional study on both the knowledge and perception of prescribers concerning the use of antibiotics and the policies on their proper use. Results: Of a total of 1,199 cases examined at the University Hospital of Conakry, 953 patients received at least one antibiotic about 79.5% of the total cases. The total amount consumed was 55.3 DDD / 100 BD. The class of the Extended-spectrum penicillin’s was widely the most used at 22.9 DDD / 100 BD. The median knowledge score of prescribers; valued at a total of 8, was equal to 5. The Composite Index for proper use of Antibiotic (CIATB) was 2.25 / 20. Determinants or factors associated with the large use of antibiotics were the hospital site, the ward and the average length of stay. Conclusion: Based on the results of our study, it appears that lot antibiotics are largely consumed at the University Hospital of Conakry; and that consumption are influenced by the hospital site, the ward and the length of stay. This study reveals also the absence of any policy of the rational use of antibiotics. Therefore, the study illustrates the need for the implementation of an antimicrobial stewardship action. [less ▲]

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See detailCommunity pharmacists' evaluation of potentially inappropriate prescribing in older community-dwelling patients with polypharmacy: observational research based on the GheOP(3)S tool.
Tommelein, Eline; Mehuys, Els; Van Tongelen, Inge et al

in Journal of public health (Oxford, England) (2016)

BACKGROUND: In this study, we aimed to (i) determine the prevalence of potentially inappropriate prescribing (PIP) in community-dwelling older polypharmacy patients using the Ghent Older People's ... [more ▼]

BACKGROUND: In this study, we aimed to (i) determine the prevalence of potentially inappropriate prescribing (PIP) in community-dwelling older polypharmacy patients using the Ghent Older People's Prescriptions community-Pharmacy Screening (GheOP(3)S) tool, (ii) identify the items that account for the highest proportion of PIP and (iii) identify the patient variables that may influence the occurrence of PIP. Additionally, pharmacist-physician contacts emerging from PIP screening with the GheOP(3)S tool and feasibility of the GheOP(3)S tool in daily practice were evaluated. METHODS: A prospective observational study was carried out between December 2013 and July 2014 in 204 community pharmacies in Belgium. Patients were eligible if they were (i) >/=70 years, (ii) community-dwelling, (iii) using >/=5 chronic drugs, (iv) a regular visitor of the pharmacy and (v) understanding Dutch or French. Community pharmacists used a structured interview to obtain demographic data and medication use and subsequently screened for PIP using the GheOP(3)S tool. A Poisson regression was used to investigate the association between different covariates and the number of PIP. RESULTS: In 987 (97%) of 1016 included patients, 3721 PIP items were detected (median of 3 per patient; inter quartile range: 2-5). Most frequently involved with PIP are drugs for the central nervous system such as hypnosedatives, antipsychotics and antidepressants. Risk factors for a higher PIP prevalence appeared to be a higher number of drugs (30% extra PIPs per 5 extra drugs), female gender (20% extra PIPs), higher body mass index (BMI, 20% extra PIPs per 10-unit increase in BMI) and poorer functional status (30% extra PIPs with 6-point increase). The feasibility of the GheOP(3)S tool was acceptable although digitalization of the tool would improve implementation. Despite detecting at least one PIP in 987 patients, only 39 physicians were contacted by the community pharmacists to discuss the items. CONCLUSION: A high prevalence of PIP in community-dwelling older polypharmacy patients in Belgium was detected which urges for interventions to reduce PIP. [less ▲]

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See detailQuality of documentation on antibiotic therapy in medical records: evaluation of combined interventions in a teaching hospital by repeated point prevalence survey.
VERCHEVAL, Christelle ULg; GILLET, Manon ULg; MAES, Nathalie ULg et al

in European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology (2016), 35(9), 14951500

This study aimed to improve the quality of documentation on antibiotic therapy in the computerized medical records of inpatients. A prospective, uncontrolled, interrupted time series (ITS) study was ... [more ▼]

This study aimed to improve the quality of documentation on antibiotic therapy in the computerized medical records of inpatients. A prospective, uncontrolled, interrupted time series (ITS) study was conducted by repeated point prevalence survey (PPS) to audit the quality of documentation on antibiotic therapy in the medical records before and after a combined intervention strategy (implementation of guidelines, distribution of educational materials, educational outreach visits, group educational interactive sessions) from the antimicrobial stewardship team (AST) in the academic teaching hospital (CHU) of Liege, Belgium. The primary outcome measure was the documentation rate on three quality indicators in the computerized medical records: (1) indication for treatment, (2) antibiotics prescribed, and (3) duration or review date. Segmented regression analysis was used to analyze the ITS. The medical records of 2306 patients receiving antibiotics for an infection (1177 in the pre-intervention period and 1129 in the post-intervention period) were analyzed. A significant increase in mean percentages in the post-intervention period was observed as compared with the pre-intervention period for the three quality indicators (indication documented 83.4 +/- 10.4 % vs. 90.3 +/- 6.6 %, p = 0.0013; antibiotics documented 87.9 +/- 9.0 % vs. 95.6 +/- 5.1 %, p < 0.0001; and duration or review date documented 31.9 +/- 15.4 % vs. 67.7 +/- 15.2 %, p < 0.0001). The study demonstrated the successful implementation of a combined intervention strategy from the AST. This strategy was associated with significant changes in the documentation rate in the computerized medical records for the three quality indicators. [less ▲]

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See detailThe heterogeneity of headache patients who self-medicate: a cluster analysis approach.
Mehuys, Els; Paemeleire, Koen; Crombez, Geert et al

in Pain (2016), 157(7), 1464-71

Patients with headache often self-treat their condition with over-the-counter analgesics. However, overuse of analgesics can cause medication-overuse headache. The present study aimed to identify ... [more ▼]

Patients with headache often self-treat their condition with over-the-counter analgesics. However, overuse of analgesics can cause medication-overuse headache. The present study aimed to identify subgroups of individuals with headache who self-medicate, as this could be helpful to tailor intervention strategies for prevention of medication-overuse headache. Patients (n = 1021) were recruited from 202 community pharmacies and completed a self-administered questionnaire. A hierarchical cluster analysis was used to group patients as a function of sociodemographics, pain, disability, and medication use for pain. Three patient clusters were identified. Cluster 1 (n = 498, 48.8%) consisted of relatively young individuals, and most of them suffered from migraine. They reported the least number of other pain complaints and the lowest prevalence of medication overuse (MO; 16%). Cluster 2 (n = 301, 29.5%) included older persons with mainly non-migraine headache, a low disability, and on average pain in 2 other locations. Prevalence of MO was 40%. Cluster 3 (n = 222, 21.7%) mostly consisted of patients with migraine who also report pain in many other locations. These patients reported a high disability and a severe limitation of activities. They also showed the highest rates of MO (73%). [less ▲]

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See detailPharmacists' role in handling problems with prescriptions for atithrombotic medication in Belgian community pharmacies
Desmaele; De Wulf, I; Dupont, AG et al

in International Journal of Clinical Pharmacy [=IJCP] (2015), 37(4), 656-668

Background Community pharmacists have an important task in the follow-up of patients treated with antithrombotics. When delivering these medicines, pharmacists can encounter drug–related problems (DRPs ... [more ▼]

Background Community pharmacists have an important task in the follow-up of patients treated with antithrombotics. When delivering these medicines, pharmacists can encounter drug–related problems (DRPs) with substantial clinical and economic impact. Objective To investigate the amount and type of antithrombotic related DRPs as well as how community pharmacists handled these DRPs. Setting Belgian community pharmacies. Methods MSc pharmacy students of six Belgian universities collected data about all DRPs encountered by a pharmacist during ten half days of their pharmacy internship. Data were registered about DRPs detected at delivery and in an a posteriori setting, when consulting the medical history of the patient. Classification of the DRP, cause of the DRP, intervention and result of the intervention were registered. Main outcome measure Amount and type of antotrombitocs related DRPs occurring in community pharmacies, as well as how community pharmacists handled these DRPs. Results 3.1 % of the 15,952 registered DRPs concerned antithrombotics. 79.3 % of these DRPs were detected at delivery and 20.7 % were detected a posteriori. Most antithrombotic-related DRPs concerned problems with the choice of the drug (mainly because of drug–drug interactions) or concerned logistic problems. Almost 80 % of the antithrombotic-related DRPs were followed by an intervention of the pharmacist, mainly at the patient’s level, resulting in 90.1 % of these DRPs partially or totally solved. Conclusion Different DRPs with antithrombotic medication occurred in Belgian community pharmacies. About 20 % was detected in an a posteriori setting, showing the benefit of medication review. Many of the encountered DRPs were of technical nature (60.7 %). These DRPs were time-consuming for the pharmacist to resolve and should be prevented. Most of the DRPs could be solved, demonstrating the added value of the community pharmacist as first line healthcare provider. [less ▲]

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See detailAsthma Control and Sputum Eosinophils: a Longitudinal Study in Daily Practice
Demarche, Sophie ULg; SCHLEICH, FLorence ULg; HENKET, Monique ULg et al

Scientific conference (2015, June 12)

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See detailTraitement personnalisé dans l'asthme : le cas des anticorps monoclonaux dirigés contre l'interleukine-5.
LOUIS, Renaud ULg; Demarche, Sophie ULg; Van Hees, Thierry ULg et al

in Revue Médicale de Liège (2015), 70(5-6), 306-9

Asthma is a chronic inflammatory disease that often features eosinophilia, especially in its most severe forms. Monoclonal antibodies directed towards interleukin-5, such as mepolizumab or reslizumab ... [more ▼]

Asthma is a chronic inflammatory disease that often features eosinophilia, especially in its most severe forms. Monoclonal antibodies directed towards interleukin-5, such as mepolizumab or reslizumab, were shown to be very effective at reducing blood and airways eosinophilia. When administered monthly by intravenous or subcutaneous injection in severe eosinophilic asthmatic patients, they reduce severe exacerbation rate by 50 %, improve asthma control and quality of life, and have an oral glucocorticoids sparing effect in those requiring oral corticoids as maintenance therapy. [less ▲]

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See detailLes génériques d’antibiotiques : une fausse bonne idée ?
Van Hees, Thierry ULg

Scientific conference (2015, March 10)

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See detailClinical drug related problems and interventions of pharmacists on prescribed medicines in Belgium
De Wulf, Isabelle; Foulon, Veerle; De Meyer, R.Y. et al

in International Journal of Clinical Pharmacy [=IJCP] (2015), 37(2), 407-408

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See detailPrésentation d'un nouveau site de données probantes pharmaceutiques
Guérin, A; Spinewine, A; Van Hees, Thierry ULg et al

in Journal de Pharmacie de Belgique (2015), 1

Conscient des choix difficiles auxquels les décideurs de la santé sont confrontés et de la volonté de développer les soins pharmaceutiques, l’équipe de l’Unité de recherche en pratique pharmaceutique du ... [more ▼]

Conscient des choix difficiles auxquels les décideurs de la santé sont confrontés et de la volonté de développer les soins pharmaceutiques, l’équipe de l’Unité de recherche en pratique pharmaceutique du CHU Sainte-Justine s’est intéressée aux preuves décrivant le rôle et les retombées des activités du pharmacien. Ce projet de recherche a pris la forme d’une démarche structurée de revue et d’analyse documentaire des preuves disponibles. Un site Internet a été développé et programmé afin d’assurer efficacement le partage des connaissances (http://impactpharmacie. org). Le site Impact Pharmacie recense les preuves du rôle et des retombées de l’activité pharmaceutique, tant en milieu hospitalier qu’en milieu ambulatoire. Ce site recense notamment douze articles issus de la littérature pharmaceutique belge ayant trait à la pratique hospitalière et communautaire. On recense quatre indicateurs de résultats avec des retombées positives (i.e. statistiquement significatives) des interventions pharmaceutiques. Ce site peut contribuer à alimenter la réflexion et les actions entourant le développement de la pharmacie clinique en Belgique. [less ▲]

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See detailPilot study about hospital pharmacy residents' perception of pharmacovigilance in Belgium, France, Canada and Switzerland
Cerruti, Léna; Lebel, Denis; Van Hees, Thierry ULg et al

in Journal of Population Therapeutics and Clinical Pharmacology (2015), 22(2), 179-188

Background: Pharmacovigilance is defined as the science and activities relating to the detection, assessment, understanding and prevention of adverse drug reactions (ADRs). Although pharmacovigilance is a ... [more ▼]

Background: Pharmacovigilance is defined as the science and activities relating to the detection, assessment, understanding and prevention of adverse drug reactions (ADRs). Although pharmacovigilance is a responsibility for all healthcare professionals, this activity is an important part of a pharmacist’s practice. Hospital pharmacy residents are expected to have the necessary skills to monitor, manage, report and prevent ADRs as a part of their academic curriculum. Assessing and comparing perceptions of pharmacovigilance of hospital pharmacy residents from four different countries can contribute to a reflection about their education and their role in pharmacovigilance. Objectives: To assess and compare the perception of pharmacovigilance of hospital pharmacy residents from Belgium, France, Quebec and Switzerland. Methods: A cross-sectional study was conducted in March 2014 using an online-questionnaire administrated to 229 hospital pharmacy residents. Nineteen questions were organized into five sections: demographic data, pharmacovigilance education and practice, attitudes toward reporting adverse drug reactions, obstacles to reporting ADRs and measures to improve ADRs reporting rate. Results: Unlike the French residents, most of the other respondents believed that they had received an adequate pharmacovigilance education. The main obstacles to ADR reporting were similar: lack of experience and concern about overwork. The same measures concerning the development of pharmacovigilance were identified. Hospital residents expected local measures for a closer pharmacovigilance. Conclusions: These observations lead us to think that standardizing and changing hospital pharmacy residents’ education and good practices in clinical pharmacovigilance are required to optimize patient care. [less ▲]

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See detailPerception de la pharmacovigilance par les futurs pharmaciens hospitaliers belges, français, québécois et suisses
Cerruti, L; Lebel, D; Van Hees, Thierry ULg et al

in Journal of Population Therapeutics and Clinical Pharmacology (2014, September 17), 21(2), 320

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See detailSelf-medication in persistent rhinitis: overuse of decongestants in half of the patients.
Mehuys, Els; Gevaert, Philippe; Brusselle, Guy et al

in Journal of Allergy and Clinical Immunology - In Practice (2014), 2(3), 313-319

BACKGROUND: Patients with rhinitis often self-medicate with over-the-counter drugs, however this self-treating population has remained largely unstudied. OBJECTIVE: To characterize individuals self ... [more ▼]

BACKGROUND: Patients with rhinitis often self-medicate with over-the-counter drugs, however this self-treating population has remained largely unstudied. OBJECTIVE: To characterize individuals self-medicating persistent rhinitis and to determine the prevalence of and risk factors for intranasal decongestant overuse within this population. METHODS: A cross-sectional observational study of individuals self-medicating persistent rhinitis (defined according to the Allergic Rhinitis and its Impact on Asthma guidelines). Participants (n = 895) completed a self-administered questionnaire to assess current symptoms, rhinitis medication, and previous physician diagnosis. Intranasal decongestant overuse was defined as daily use for at least 1 year. RESULTS: The vast majority of subjects (95%) had moderate-to-severe rhinitis. Nasal congestion was the predominant symptom (median visual analog scale, 6.6 cm; interquartile range, 3.4 cm). Sixty-five percent had had their current nasal problems for more than 5 years. Approximately 80% had a physician diagnosis (mainly allergic rhinitis or rhinosinusitis). The prevalence of intranasal decongestant overuse was high (49%), despite the fact that most of the patients (80%) were educated about the limit on duration of use. Use of intranasal glucocorticosteroids was inversely related to being an overuser (odds ratio 0.24 [95% CI, 0.17-0.35]). The risk of intranasal decongestant overuse also was reduced by use of other medications (oral H1 antihistamines and decongestants), use of nasal saline solution, and more symptoms of itchy and/or runny eyes or colored mucus. Risk was increased by a more severely blocked nose, longer duration of symptoms, the presence of sleep disturbance, higher body mass index, and previous advice to limit the duration of intranasal decongestant use. CONCLUSION: Half of the individuals self-medicating persistent rhinitis overused intranasal decongestants, despite the fact that they were educated about the limit on duration of use. [less ▲]

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