Accepted for/Published in: JMIR Medical Education
Date Submitted: Aug 20, 2020
Date Accepted: Nov 15, 2020
The quality of instructional videos for administration of intranasal spray on YouTube: an observational study
ABSTRACT
Background:
Allergic rhinitis is a common disorder affecting both children and adults. Recommended treatment consists of intranasal corticosteroid spray but only few patients administer the nasal spray in a correct technical manner. Wrong administration technique affects side effects, efficacy and adherence, making instructions indispensable. Unfortunately, it turns out to be difficult for patients to obtain information of good quality.
Objective:
In this study, we analysed instruction videos available on YouTube for the administration of nasal sprays for allergic rhinitis. Our aim was to determine if the videos provide instructions in accordance with the standardised nationwide patient protocol in the Netherlands for intranasal spray administration.
Methods:
Instruction videos for aqueous formulations for nasal spray for allergic rhinitis were found on YouTube. All videos were reviewed by two researches and scored using the instructions from the Dutch standardised protocol. When a correct instruction was given, a 1 was scored, an incorrect or missing instruction scored 0. The ‘inter-rater reliability Cohen’s ĸ’ was used to determine differences in the score between the researchers.
Results:
We identified 33 YouTube videos made by different healthcare professions and pharmaceutical companies around the world. In 0 of 33 videos (0%) were all steps displayed correctly, and 5 of 33 (15%) videos displayed over 75% of the steps correctly. The median score of correctly displayed steps was 11 out of 19 (range = 2 – 17; IQR = 6). The inter-rater reliability Cohen’s ĸ’ were all statistically significant (range = 0.872 – 1.00, P<.001). The steps ‘neutral position of the head’, ‘breathing out through the mouth’ and ‘periodically cleaning with water’ scored worst and were incorrectly displayed in 28 out of 33 (85%), 28 out of 33 (85%) and 30 out of 33 (91%) of the videos respectively.
Conclusions:
The minority of the instruction videos that can be found on YouTube are providing correct instructions for the administration of nasal sprays to patients. This may lead to confusion in patients and incorrect use of the nasal spray. In the future, it is important to make evidence-based instruction videos which show patients the correct administration technique. Clinical Trial: Not applicable
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