The current burden of allergic rhinitis amongst primary care practitioners and its impact on patient management

Abstract

Aims: To investigate the burden of allergic rhinitis (AR) amongst primary care practitioners (PCPs), the impact of AR on PCPs' professional lives, and the effect on their management of AR patients of PCPs' personal experience of AR.Methods: An online questionnaire was completed by 1201 PCPs (50% AR sufferers) from eight countries.Results: 21% of PCPs reported very well controlled symptoms and 66% quite good control. Six hours work per week, on average, was missed by PCPs whose AR symptoms resulted in absence. AR symptoms affected concentration, stress level, mood, time spent with patients, physical contact with patients, and patient throughput. PCPs with AR reported a significantly higher proportion of AR patients in their practice and gave a significantly higher ranking to specific treatment requests and emotional well-being, and gave a significantly lower ranking to preventing comorbidity development and providing a treatment most likely to result in high patient compliance.Discussion: This is the first study demonstrating the impact of AR on PCPs showing association with lost productivity, absenteeism and reduction in professional performance. Personal experience of AR significantly influences PCPs' management of AR and may improve their AR diagnostic ability.

Sneezing and Runny Nose: Should Allergy Testing Be Routinely Performed?

“…It is believed that patients with AR often have prominent sneezing, runny nose and they may have a very itchy nose and itchy eyes, which is not frequently seen in nonallergic rhinitis [6][7][8][9][10][11]. However, this study did not support this idea.…”

Asthma with allergic rhinitis management in China: a nationwide survey of respiratory specialists at tertiary hospitals

“…In comparison, 52% of primary care practitioners from 8 countries recommended intranasal corticosteroids for treatment of patients with severe AR (without asthma). 10 In the present study, approximately 21% of PRMs preferred leukotriene modifiers as the most common medication for treating AR symptoms of patients with the Asthma occurs first, which is followed by allergic rhinitis In 350 Flemish general practitioners, proposed therapeutic strategies for AR differed by clinical experience; those with ࣘ5 years clinical experience were more compliant with ARIA guidelines. 19 Although most physicians independent of experience and professional titles chose nasal steroids as the most commonly used medication for treatment of AR in asthma-AR patients in the present study, differences in prescribing other treatments were noted.…”

“…6 Furthermore, the prescription choices in this survey likely underestimate the number of medication combinations prescribed by physicians because primary care practitioners had listed more than 450 combinations for the treatment of severe AR in the absence of asthma, the most frequent combination being an oral antihistamine with an intranasal corticosteroid. 10 This study has limitations that warrant further discussion. Because the participating PRMs practice at tertiary general hospitals, the survey results may not represent the current understanding of asthma-AR comorbidity among physicians in primary or secondary hospitals.…”

“…4 Alternatively, the patients of some PRMs may be less forthcoming about symptoms associated with AR, and some PRMs may be less aware of AR symptoms in their asthma patients and may not uncover the associated morbidity, as physicians in Otolaryngology may have a greater ability to diagnose AR. 10 We recommend that PRMs query all asthma patients regarding AR symptoms, irrespective of the presence or a previous diagnosis of AR. We also recommend that PRMs consider the use of the skin-prick test in asthma patients with some AR-like symptoms in the upper respiratory tract to aid in the diagnosis and possible identification of the offending allergens and/or irritants.…”

“…3 Although the guidelines of the ARIA are comprehensive, only 30% of primary care physicians use or adapt them during the management of their individual AR patients. 10 Similarly, some physicians may not fully follow the recent guidelines in the treatment of asthma, 1,[11][12][13] resulting in a gap between the guidelines and clinical practice in prescribing medications. 14 Management of patients with both asthma and AR provide additional challenges 11 over patients with a single respiratory ailment.…”