LA ADHERENCIA AL TRATAMIENTO CON CORTICOIDES TÓPICOS EN LA RINOSINUSITIS CRÓNICA CON PÓLIPOS NASALES: REVISIÓN DE LA LITERATURA

Juan Maza-Solano

Resumen


INTRODUCCIÓN

La rinosinusitis crónica con pólipos nasales es una patología con un elevado coste sociosanitario. La base de su tratamiento son las irrigaciones salinas endonasales y la terapia intranasal corticoidea. En muchas ocasiones se consigue un correcto control de la enfermedad mediante este primer escalón terapéutico, pero es necesario mantener una buena adherencia terapéutica. A diferencia del asma, donde existen muchos estudios sobre la adherencia terapéutica, en la poliposis nasal hay poca evidencia sobre el impacto de la participación del paciente en los resultados del plan de tratamiento.

Esta revisión pretende exponer la situación actual de la adherencia a los corticoides intranasales en la poliposis nasosinusal.

 

RESULTADOS

            Los valores de eficacia de las terapias intranasales para la poliposis están limitados por cuestiones asociadas al propio comportamiento del paciente o a la existencia de predictores críticos de la adherencia.

            Se estima que la adherencia a las terapias intranasales para la poliposis nasal se encuentra entre el 10%-20%, aunque estos valores varían significativamente según la asociación con otras enfermedades comórbidas como el asma, a intervenciones quirúrgicas o a aspectos geográficos y socioculturales.

            No existe ningún test específico sobre adherencia terapéutica en poliposis nasal para los CIN publicado en la actualidad.

 

CONCLUSION

En un contexto de falta de evidencias, se estima que las tasas de incumplimiento por la falta de adherencia terapéutica intranasal en los pacientes con poliposis nasal son elevadas. Es preciso evaluar los factores asociados a la infrautilización terapéutica de primer nivel, para optimizar su beneficio y el mejor control de la enfermedad nasosinusal

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Referencias


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