Abstract
BACKGROUND: Although nasal decongestants are commonly used to treat respiratory symptoms, their inappropriate use may lead to complications such as rhinitis medicamentosa. There is a lack of research examining patterns of use and knowledge in Saudi Arabia, particularly in the Jazan Region. AIM: This study aimed to evaluate the knowledge, patterns, and factors related to nasal decongestant use among adults in the Jazan Region of Saudi Arabia. METHODS: A cross-sectional study was conducted between January and June 2024. Data were collected through an online survey distributed via social media platforms. The validated Arabic online questionnaire collected data on the sociodemographic profile, patterns of use, and knowledge of nasal decongestants from 439 participants aged 18 years and above. Appropriate use was defined as obtaining the medication from healthcare facilities or using it for less than five days with a maximum of three doses per day. The data were analyzed descriptively and using bivariate and multivariate logistic regression models. RESULTS: The participants were predominantly young (average age, 27.8 years), female (65.4%), and university educated (67.9%). Of the 312 users, 57.1% demonstrated an appropriate duration of use (less than five days), and 42.9% exceeded the recommended duration of use. Regarding concerning patterns, 75% procured decongestants illegally from pharmacies and 25% self-medicated. There were significant knowledge gaps, with only 35.5% of participants aware of the rebound congestion risk and 43.1% incorrectly believing that decongestants were safe for all children. A strong dose-response relationship was observed between knowledge and appropriate use, with 32.1% and 71.2% for the low and high knowledge tertiles, respectively (p < 0.001). Employment in healthcare (adjusted odds ratio (AOR) = 2.45; p < 0.001) and postgraduate qualifications (AOR = 3.21; p = 0.003) were the strongest predictors of appropriate usage. The rate of complications significantly increased with a duration of use greater than seven days (risk ratio (RR) = 5.63; 95% CI: 2.17-14.59). CONCLUSIONS: Significant knowledge gaps and patterns of inappropriate nasal decongestant use were observed among the residents of Jazan. There is a need for tailored educational strategies that address appropriate usage, duration, healthcare worker status, and raters with lower levels of educational attainment.