Factors Impacting Adherence to Saline Nasal Irrigation Treatment in an Urban Population

Tuesday, October 14, 2025

8:48 AM - 8:54 AM EDT

Location: 125

Disclosure(s):

Anusha Ponduri, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Christina H. Fang, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Saline nasal irrigation (SNI) is considered first-line treatment for allergic rhinitis and chronic sinusitis. We aim to identify barriers to SNI adherence in our urban patient population.

Methods: Patients treated for allergic rhinitis or chronic sinusitis over the age of 18 in January 2024 at Montefiore Medical Center were identified using ICD diagnosis codes. The electronic medical records of these patients were reviewed. These patients were then contacted via phone survey, to investigate barriers to compliance. Univariate analysis was performed to compare demographic and clinical factors with patient compliance. Adherence to SNI was defined as performing SNI according to listed steps at least twice a day.

Results: A total of 174 patients were surveyed. 68 patients were adhering to SNI (39.08%). Univariate analysis showed a significant association between adherence and primary language of English (p=0.026), history of allergies (p=0.043), and borderline significant association with prior sinus surgery (p=0.053). Among the patients who did not perform SNI at all (n=65), the most commonly cited barrier was issues with time commitment (n=18; 27.69%), finding SNI to be uncomfortable (n=15; 23.07%), finding SNI to not be helpful (n=9; 13.85%), and difficulty following instructions (n=7; 10.77%). The most commonly listed intervention to improve compliance among all surveyed patients was increased education on the importance of SNI and teaching patients how to use SNI (n=57; 32.76%). This was followed by offering patients a list of affordable options and cost transparency (n=26; 14.94%), and assistance with setting up reminders to perform SNI (n=22; 12.64%).

Conclusions: In our urban patient population, we found adherence to SNI is only 39.08%. Factors associated with compliance included primary language of English, history of allergies, and prior sinus surgery. We identified issues with logistics, discomfort when performing SNI, and following instructions as barriers. Areas of intervention based on survey responses include patient education, cost transparency and assistance with setting up reminders.

Presenting Author(s)

Anusha Ponduri, MD

Resident Physician
Montefiore Medical Center/Albert Einstein College of Medicine
Bronx, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Raena E. Greenbaum, BA

Medical Student
Albert Einstein Medical School
Bronx, NY, United States

Disclosure information not submitted.
Manish S. Bhatta, BS

Medical Student
Albert Einstein Medical School
Bronx, NY, United States

Disclosure information not submitted.
AF

Anastasia Fotis, BA

Albert Einstein Medical School, United States

Disclosure information not submitted.
CR

Carolyn J. Rachofsky, BA

Medical Student
Albert Einstein Medical School
New York, NY, United States

Disclosure information not submitted.
AL

Alice Lee, MD

Montefiore Hospital / Albert Einstein College of Medicine - - Bronx, NY, United States

Disclosure information not submitted.
NA

Nadeem A. Akbar, MD

Associate Professor
Montefiore
Bronx, New York, United States

Disclosure information not submitted.
PC

Patrick M. Colley, MD

Associate Professor of Otolaryngology and Neurosurgery
Albert Einstein College of Medicine - Montefiore Medical Center
Bronx, NY, United States

Disclosure information not submitted.

Senior Author(s)

Christina H. Fang, MD

Attending Physician, Assistant Professor
Montefiore Medical Center, Department of Otorhinolaryngology- Head and Neck Surgery
Bronx, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.