Prevalence, Usage Patterns and Side Effects of Nasal Decongestants Among the General Population in Arar City: A Cross-Sectional Study
Basem Salama, Yahia Abdelgawad Elsayed Elboraei, Awwad Alenezy, Mugrin Radi A. Alrwaili, Abdullah Shafi Alanazi, Feras Hamad Alanazi, Fayez Nasser Alsaiari
Abstract
Background: Nasal congestion, characterized by blocked airflow in the nasal cavity, is a common clinical symptom often caused by structural abnormalities, infections, or allergic rhinitis. Nasal decongestants are frequently used for symptomatic relief; however, excessive use can lead to complications such as rhinitis medicamentosa and other adverse effects. Despite their widespread use, public awareness of appropriate usage practices remains limited. Objective: This study aims to assess the prevalence, usage patterns and associated side effects of nasal decongestants among adults in the Northern Border Governorate, Saudi Arabia, while highlighting knowledge gaps in safe usage practices. Methods: A cross-sectional study was conducted among 436 adults aged >18 years using a structured, validated questionnaire. Data on demographics, duration of use and reported side effects were collected and analyzed using SPSS (version 22). Chi-square and t-tests were employed to assess associations between nasal decongestant use and demographic variables such as age, gender, marital status and education. Results: Of the 436 participants, 64% reported using nasal decongestants. Usage was significantly higher among individuals aged 31-45 years (p = 0.001), married individuals (p = 0.001) and those with higher education levels (p = 0.001). Common usage reasons included the common cold (39%) and nasal obstruction (16%). Pharmacists were the primary source of guidance (43.4%), while physician recommendations accounted for only 19.4%. Alarmingly, 59.1% reported prolonged use (3-5 days) and 9.3% exceeded the recommended 5-day limit. Side effects were prevalent, with dryness (55.9%), anxiety (54.1%) and headache (51.6%) being the most frequently reported. Conclusion: The study reveals a high prevalence of nasal decongestant misuse, with extended use and reliance on non-professional advice contributing to significant side effects. These findings highlight the urgent need for targeted public awareness campaigns emphasizing the risks of prolonged decongestant use and promoting safe practices. Improved pharmacist training and stricter regulatory control of over-the-counter decongestants are essential. Future research should explore long-term health impacts, investigate self-medication behaviors and assess the efficacy of educational interventions in reducing misuse.