A patient-centric analysis to identify key influences in allergic rhinitis management

Abstract

Allergic rhinitis (AR) is increasingly becoming a patient self-managed disease. Just under 70% of patients purchasing pharmacotherapy self-select their treatment with no health-care professional intervention often resulting in poor choices, leading to suboptimal management and increased burden of AR on the individual and the community. However, no decision is made without external, influencing forces. This study aims to determine the key influences driving patients’ decision-making around AR management. To accomplish this aim, we utilised a social network theory framework to map the patient’s AR network and identify the strength of the influences within this network. Adults who reported having AR were interviewed and completed an AR network map and AR severity and quality of life questionnaires. Forty one people with AR completed the study. The AR networks of the participants had a range of 1–11 influences (alters), with an average number of 4 and a median of 5. The larger the impact of AR on their quality of life, the greater the number of alters within their network. The three most commonly identified alters were, general practitioners, pharmacists and the participants’ ‘own experience’. The strength of the influence of health-care professionals (HCPs) was varied. The proportion of HCPs within the AR network increased as the impact of AR on their quality of life increased. By mapping the AR network, this study demonstrated that there are multiple influences behind patient’s decisions regarding AR management but the role of the HCP cannot be dismissed.

Exploring the Asthma Network in People with Allergic Rhinitis Utilizing an Egocentric Social Network Analysis

“…To investigate whether patient asthma management behaviour is influenced by having AR, we can start by mapping the asthma health network for people with asthma and AR. We hypothesize that the map will be different to the asthma map defined by Cheong et al and that some of the influences identified in the AR network [21] will appear within the asthma map of those with AR.…”

“…This study used a mixed methods approach based on the theoretical and analytical framework of social network theory as previously developed and utilized by Cheong et al [22] and Cvetkovski et al [21]. Specifically, this study used an egocentric social network framework; it focused on the network of an individual/'ego' (the participant) and the relationships/ 'ties' with individuals or resources/'alters'.…”

“…A convenience sample of people who had recently participated in a study at the Woolcock Institute about their AR network [21] were asked if they also had asthma and invited to participate in this study. Written consent was obtained from participants prior to commencement in the study.…”

“…Mapping of the asthma health network: An adapted concentric circle framework was used as the basis for the generation of each asthma network map [29]. The participant was asked to visually depict their relationship with each of their alters with respect to their influence on their asthma management, by mapping them on a concentric circle diagram [21]. The red circle in the centre represents the participants and each ring around the centre represents the strength of influence that an alter has on their asthma management, i.e.…”

“…Social network research of AR management from the patient's perspective further details the extent of influence of patient-driven self-management. Social network investigations of key influences on patient's AR decision-making demonstrated that the patients 'own experience' was the third most influential factor, behind advice from a general practitioner (GP) and pharmacist [21]. When considering these findings, one considers whether this prominent patient confidence in their ability to self-manage their own condition is specific to AR or common to AR and asthma in people with both co-morbidities.…”