Using nasal sprays to prevent respiratory tract infections: a qualitative study of online consumer reviews and primary care patient interviews

Sian Williamson, Laura Dennison*, Kate Greenwell, James Denison-Day, Fiona Mowbray, Samantha Richards-Hall, Deb Smith, Katherine Bradbury, Ben Ainsworth, Paul Little, Adam W A Geraghty, Lucy Yardley

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

6 Citations (Scopus)
39 Downloads (Pure)


OBJECTIVES: Nasal sprays could be a promising approach to preventing respiratory tract infections (RTIs). This study explored lay people's perceptions and experiences of using nasal sprays to prevent RTIs to identify barriers and facilitators to their adoption and continued use.

DESIGN: Qualitative research. Study 1 thematically analysed online consumer reviews of an RTI prevention nasal spray. Study 2 interviewed patients about their reactions to and experiences of a digital intervention that promotes and supports nasal spray use for RTI prevention (reactively: at 'first signs' of infection and preventatively: following possible/probable exposure to infection). Interview transcripts were analysed using thematic analysis.

SETTING: Primary care, UK.

PARTICIPANTS: 407 online customer reviews. 13 purposively recruited primary care patients who had experienced recurrent infections and/or had risk factors for severe infections.

RESULTS: Both studies identified various factors that might influence nasal spray use including: high motivation to avoid RTIs, particularly during the COVID-19 pandemic; fatalistic views about RTIs; beliefs about alternative prevention methods; the importance of personal recommendation; perceived complexity and familiarity of nasal sprays; personal experiences of spray success or failure; tolerable and off-putting side effects; concerns about medicines; and the nose as unpleasant and unhygienic.

CONCLUSIONS: People who suffer disruptive, frequent or severe RTIs or who are vulnerable to RTIs are interested in using a nasal spray for prevention. They also have doubts and concerns and may encounter problems. Some of these may be reduced or eliminated by providing nasal spray users with information and advice that addresses these concerns or helps people overcome difficulties.

Original languageEnglish
Article numbere059661
JournalBMJ Open
Issue number6
Publication statusPublished - 30 Jun 2022

Bibliographical note

Funding Information:
This study/project is funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research (PGfAR) programme. This study was nested within an NIHR Programme Grant for Applied Research: REducing Common infections in Usual practice for Recurrent Respiratory tract Infections (RECUR) (PL, AWAG) (RP-PG-0218-20005). LY is an NIHR senior investigator and her research programme is partly supported by the NIHR Applied Research Collaboration (ARC)-West, the NIHR Health Protection Research Unit (HPRU) for Behavioural Science and Evaluation and the NIHR Southampton Biomedical Research Centre (BRC). The research programmes of LY and JD-D are partly supported by the NIHR BRC. The intervention development methods used for the RECUR/‘Immune Defence’ intervention were developed with support from the NIHR BRC.

Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Structured keywords

  • Physical and Mental Health


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