Strategies for the management of intermittent allergic rhinitis: an Australian study (original) (raw)
Related papers
Allergy, 2002
Background: The actual management of intermittent allergic rhinitis is still little known about, despite the disease being very prevalent. We used a cross-sectional survey to address this issue in everyday general medical practice in France. Methods A total of 1321 general practitioners enrolled 3026 patients consulting for a spring exacerbation of allergic rhinitis. Both doctors and patients filled out a specific questionnaire on allergic rhinitis. Results These patients consulted their doctor two-and-a-half weeks, on average, after the onset of their symptoms. They were bothered for an average of six days per week (5.9t1.7 days) and for two months per year (8.7t7.7 weeks) by symptoms which largely exceed the ENT (ear, nose and throat) field, with ocular symptoms (51.7%), pharyngeal irritation (39.0%), cough (30.8%), or respiratory discomfort (17.9%). Of these patients 79.2% had some impairment of their professional life and 91.8% of their daily life. Fifty percent of patients knew to what allergens they were allergic; only 11.1% had additional laboratory tests and 10.3% had subsequent specialist consultation (for most this was with an allergologist). Prescribed drugs were oral antihistamines (92.4%) and nasal glucocorticosteroids (45.2%). Prescriptions were written for a duration of six weeks on average. Seventy-nine percent of patients considered that the information they had received was adequate and easy to understand, but 58.2% of patients would have liked more advice. Furthermore, only 54.7% followed their doctor's prescription scrupulously, and 44% used frequent self-medication. Conclusions Intermittent allergic rhinitis is a real health problem because of its increasing prevalence, the induction of impaired quality of life and loss of performance, especially at work. General practitioners play a major role in this disorder; they make the diagnosis, start the treatment, give the relevant information, and monitor most of the patients.
Optimising the management of allergic rhinitis: an Australian perspective
The Medical journal of Australia, 2005
Allergic rhinitis (AR) is one of the most prevalent medical conditions. It has significant effects on quality of life and can have considerable socioeconomic effects. The traditional classification of perennial and seasonal rhinitis does not distinguish between provoking factors, nor does it indicate the most appropriate treatment. A more useful classification is based on symptoms, which may be intermittent or persistent, and vary widely in severity. The goal of management is to achieve optimal symptom control. Therapeutic options include allergen avoidance, pharmacotherapy and immunotherapy. Antihistamines and intranasal corticosteroids (INCS) have become the cornerstones of therapy. A variety of effective treatments are available for consumers to self-select, without the advice of a doctor or pharmacist. INCS are widely recognised as the most effective pharmacotherapy for AR, in both adults and children. The efficacy of various preparations is similar, but those with low systemic ...
The international survey on the management of allergic rhinitis by physicians and patients (ISMAR)
World Allergy Organization Journal, 2015
Epidemiologic studies suggest that the prevalence of allergic rhinitis (AR) is rising worldwide. Several reports, in fact, indicate increasing trends in the prevalence of AR especially in developing countries, likely related to the environment and climate changes and the adoption of an urbanized Western lifestyle. The primary objective of the present study was to collect information about management in real-life settings, including a characterization of typical patients' profile referring to physicians, the disease features, the common approaches to diagnostic assessments and therapeutic decisions. This was an international, multicenter, cross-sectional study conducted in adults or children (≥6 years) suffering from rhinitis confirmed by physician's diagnosis for at least one year. The 234 physicians who participated in the study included a total of 2778 patients in Egypt, Mexico, Brazil, Colombia, Guatemala, Iran, Venezuela, Argentina, Israel, Kuwait and United Arab Emirates. It was found that clinical history was the selected tool to diagnose and categorize AR patients (97.1%), with less than half of patients undergoing allergy testing, may be explaining the scarce use of immunotherapy on management of disease. Out of 2776 patients, 93.4% had somehow received a recommendation to avoid allergens and irritant agent exposure. Notably, 91.4% were receiving at least one treatment at the time of the survey, mostly oral antihistamines (79.7%) and intranasal corticosteroids (66.3%). Oral antihistamines, intranasal steroids and decongestants were considered both safe and effective by patients and physicians, preferring oral and nasal route of administration. The ISMAR registry was designed according to the most accepted epidemiological recommendations, and provides interesting information regarding the management of rhinitis from a patient and physician points of view, with many similarities between the participating countries. Further efforts are required to better manage AR and its comorbidities.
Management of allergic and non-allergic rhinitis: a primary care summary of the BSACI guideline
2010
Rhinitis is a common problem in primary care which is often managed sub-optimally. It causes considerable morbidity and has been shown to have a detrimental impact on people's ability to concentrate at school and at work. Rhinitis and asthma often present together, and symptomatic rhinitis can be associated with poor asthma control and increased risk of exacerbations. There is therefore a clear need to recognise and treat rhinitis according to guideline recommendations.
Allergic Rhinitis: Treatment Based on Patient Profiles
The American Journal of Medicine, 2006
Allergic rhinitis is a common medical condition characterized by nasal, throat, and ocular itching; rhinorrhea; sneezing; nasal congestion; and, less frequently, cough. The treatment of allergic rhinitis should control these symptoms without adversely affecting daily activities or cognitive performance and should prevent sequelae such as asthma exacerbation or sinusitis. This review describes a stepwise approach to treatment of allergic rhinitis derived from a synthesis of clinical trial results, patient preferences, and real-world tolerability data. Key clinical considerations include frequency and intensity of symptoms, patient age, comorbidities, compliance with treatment regimens (influenced by formulation, route and frequency of administration), and effects on quality of life. Oral second-generation antihistamines, versus first-generation agents and inhaled corticosteroids, should be considered first-line treatment because they provide rapid relief of most allergic rhinitis symptoms without safety and tolerability issues. Additional therapeutic agents can then be added or substituted based on individual symptom response.
SAGE Open Medicine, 2015
Objective: Allergic rhinitis is a common, usually long-standing, condition that may be self-diagnosed or have a formal diagnosis. Our aim was to identify how allergic rhinitis sufferers self-manage their condition. Methods: A sample of 276 self-identified adult allergy sufferers pooled from social media completed an online survey comprising 13 questions. The survey was fielded by a professional research organization (Lab42). The main outcome measures included the use of prescription and/or non-prescription allergy medication, and interactions with physician and/ or pharmacist with respect to medication use. Results: Of the respondents, 53% (146/276) indicated that they used both prescription and over-the-counter medication to manage their allergy symptoms. Of those who used prescription medication, 53% reported that they discussed their prescription medication in great detail with their physician when it was prescribed, while 42% spoke about it briefly. Following the initial prescription, few discussions about the prescription occur with the physician (45% indicate several discussions, 40% indicate one or two discussions, and 10% indicate no discussions). In most cases (~75% of the time), allergy prescription refills did not require a doctor visit with patients obtaining refills through phone calls to the doctor's office or through the pharmacy. Two-thirds of patients (69%) report that they have discussed their prescription allergy medication with a pharmacist, with greater than half of respondents having discussed the use of the non-prescription medication with their doctor. Conclusion: Patients with diagnosed allergic rhinitis appear to be self-managing their condition with few interactions with their doctor about their allergy prescription. Interactions with a pharmacist about allergy medication (prescription and nonprescription) appear to be more common than interactions with a physician.
The patient with rhinitis in the pharmacy. A cross-sectional study in real life
Asthma Research and Practice, 2015
Background: In the practical management of allergic rhinitis (AR), pharmacists are usually the first-line contact, also because some medications are available as over the counter. Therefore, pharmacists may represent an important resource, in mediating the interaction between patients and physicians. We evaluated the clinical/ demographic characteristics of patients with respiratory allergies who consulted their pharmacists as first-line contact. A patient-oriented questionnaire was developed by a scientific committee including pharmacists, GPs, allergists, pulmonologists and ENT specialists. Methods: The questionnaire consisted of items covering the general aspects of AR. Allergic Rhinitis and its Impact on Asthma guidelines were assumed as reference for diagnosis and therapy. The questionnaire was distributed to pharmacies, and pharmacists were asked to deliver the questionnaire to all patients referring for nasal symptoms. Results: 30 pharmacies were involved during the pollen season 2011, and 410 patients (55 % male) participated. The most frequent complaints were 20 rhinitis (49 %) and conjunctivitis (29 %), followed by lower respiratory symptoms (cough and/or dyspnea). Isolated conjunctival symptoms were present in only 22 % of patients. Among patients with lower respiratory symptoms, cough was the most frequent, variously associated with upper respiratory symptoms or overt dyspnea. Dyspnea alone was present in 16 % of patients. 39 % of patients had no physician-based diagnosis. Oral antihistamines were the most used self-medication, followed by intranasal decongestants. 30 % of respondents had used alternative medicines. Conclusion: According to these data, AR is still considered a trivial disease, frequently self-managed, with over the counter medications, not in line with guidelines. A physician-based diagnosis is present in about 60 % of patients.
151 International Survey on the Management of Allergic Rhinitis by Physicians and Patients (ISMAR)
World Allergy Organization Journal, 2012
Epidemiologic studies suggest that the prevalence of allergic rhinitis (AR) is rising worldwide. Several reports, in fact, indicate increasing trends in the prevalence of AR especially in developing countries, likely related to the environment and climate changes and the adoption of an urbanized Western lifestyle. The primary objective of the present study was to collect information about management in real-life settings, including a characterization of typical patients' profile referring to physicians, the disease features, the common approaches to diagnostic assessments and therapeutic decisions. This was an international, multicenter, cross-sectional study conducted in adults or children (≥6 years) suffering from rhinitis confirmed by physician's diagnosis for at least one year. The 234 physicians who participated in the study included a total of 2778 patients in Egypt,