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Effective SDM has been shown to improve adherence and lead to better outcomes. SDM should be universally implemented as a key component of patient-centered health care. Allergy health care providers should work with their patients to reach treatment decisions that align with their values and preferences.

Shared decision making (SDM) is a management paradigm that empowers patients as partners in their own care in a bidirectional exchange of information and values, and optimize the decision-making process. During the current coronavirus disease 2019 pandemic, there is a greater need to encourage participation in the SDM process. The pandemic has created both challenges and opportunities for delivering care, as system adaptations influence the physician-patient relationship. Although social distancing and health service reallocation can interfere with preference for an in-person visit, these measures also provide an avenue to study and implement virtual SDM processes. Communicating risk at a time of heightened uncertainty may pose a barrier to SDM engagement but provides the opportunity to foster a patient-centered approach within a more personalized context. Social media influence during coronavirus disease 2019 has resulted in an “infodemic” but highlights the importance of patient engagement. The pandemic has changed how we deliver care but allows us to re-evaluate common practices and enhance effectiveness of our management strategies. Navigating the uncertainty of subsequent pandemic waves creates confusion about how to safely reinitiate clinical service. This will require ongoing SDM with our patients and among colleagues through current—and future—challenges. Coronavirus disease 2019 has created many difficulties but has forced us to reexamine how to provide more patient-centered and high-quality care.

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Medical advances have allowed many patients with chronic diseases to lead relatively normal lives, but disparity between patient perceptions of "normal" and therapeutically defined disease control contributes to lowered adherence to treatment. This disconnect is greatest in diseases such as allergic rhinitis (AR) in which patients experience varying symptom severity over time-from asymptomatic periods to episodes of severe illness. This study was designed to evaluate the concept of adherence as applied to patients with AR. We reviewed the published literature. Adherence (or nonadherence) is an active process involving decision making on the part of the patient. Poor adherence with therapy can be the major barrier to achieving disease control, and the "on again, off again" approach to AR treatment embraced purposely by some patients may contribute to symptom lability, disease exacerbations, and higher costs. Evidence from surveys suggests that although specific educational interventions can temporarily improve adherence, in the long term most patients eventually revert to their former behavior. The available data suggest a need to reappraise how we address adherence with therapy in patients with chronic diseases with variable symptoms such as AR. The question is not just whether patient behavior can conform to recommended treatment plans, but whether it should. Experience suggests that successful strategies will be brief, easy to use, and capable of being tailored to individual patients in diverse clinical settings. Increased flexibility with medications is a corollary, particularly when patients are relatively asymptomatic (i.e., considered in control).