“A year-long, fortnightly, observational survey in three European countries of patients with respiratory allergies induced by house dust mites: Methodology, demographics and clinical characteristics”

Abstract

BackgroundHouse dust mite (HDM) allergens constitute the leading trigger for the symptoms of persistent respiratory allergies (such as allergic rhinitis and asthma). However, the fluctuating, pernicious nature of the symptoms has given rise to a perception that HDM-induced respiratory allergy is not a “real” disease.MethodsIn order to assess the self-reported disease profile and behaviour of adult patients with a self-reported history of severe, poorly controlled, physician-diagnosed HDM respiratory allergy, we performed an observational, international, multicentre survey in three European countries (France, Italy and Spain). Participants were included in the survey if they passed a short Internet-based screening questionnaire. Following completion of a detailed post-inclusion questionnaire, 28 fortnightly telephone interviews were used to gather extensive data on the participants’ symptom prevalence and intensity, medical consultations, disease burden, quality of life, and medication use from late May 2012 to early July 2013.ResultsTwenty-two thousand nine hundred ninety five individuals completed the Internet screening questionnaire and 339 respondents (67 % female) met all the inclusion criteria. 313 of the 339 (92 %) completed the post-inclusion questionnaire (n = 114 in Italy, 92 in France and 107 in Spain). The median time since the first symptoms of HDM allergy was over 13 years in all three countries. The response rate for the fortnightly interviews averaged 75 % (range: 29 to 97 %). The reported fortnightly prevalence of nasal and ocular symptoms peaked in the autumn (September to November) and spring (March to May). These peaks in prevalence coincided with increased reports of symptom worsening and higher physician consultation rates. In participants not allergic to pollen, the autumn and spring peaks were accompanied by a third peak in late December 2012. Very few participants reported that their symptoms had never improved (4 %) or never worsened (11 %) during the survey period.ConclusionsIn a survey in France, Italy and Spain, patients with severe HDM-induced respiratory allergies experienced a complex set of changing, troublesome symptoms throughout the year, with peaks in spring, autumn and (to a lesser extent) mid-winter.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-016-0246-9) contains supplementary material, which is available to authorized users.

The disease burden in patients with respiratory allergies induced by house dust mites: a year-long observational survey in three European countries

“…Every 2 weeks, the study participants underwent a detailed telephone interview on the intensity of nasal, ocular and respiratory symptoms and the latter's impact on a number of daily activities and QoL parameters. The time trends for the nasal, ocular and respiratory symptoms were similar: the fortnightly prevalence fell during the summer of 2012, rose in the autumn (peaking in early October), fell over the winter, peaked again in the spring of 2013, and then fell over the summer, as previously reported [12].…”

“…The design and procedures of this observational, Internet‐ and telephone‐based survey have been described in detail elsewhere (Fig. 1 ) [12 ]. In each country, members of nationwide patient panels (previously constituted by the study's contract research organisation STETHOS (Sèvres, France)) were invited to participate.…”

“…In view of the importance of this topic and the limitations of a previous study in Australia (a small number of participants, a single‐centre design and a small number of outcomes), we performed an observational, multinational, multicentre survey of adult patients with a history of moderate‐to‐severe, poorly controlled, physician‐diagnosed HDM respiratory allergy who had not received allergen immunotherapy [12 ]. The study took place in three Western European countries: France, Italy and Spain.…”

“…Fortnightly telephone interviews were used to gather data on symptom prevalence and intensity, medical consultations, disease burden, quality of life (QoL) and medication use over a 13‐month period of ‘real life’. Our results concerning the study population's baseline characteristics and the subsequent changes over time in the prevalence of nasal and ocular symptoms, the worsening of symptoms and physician consultations were published recently [12 ].…”

Allergens Are Not Detected in the Bronchoalveolar Lavage Fluid of Patients Undergoing Fiberoptic Bronchoscopy

“…In our area, the allergens evaluated are mainly seasonal, with maximum incidences in specific seasons. House dust mites peak in spring and autumn [8], fungal spores in summer and autumn [9], and grass pollen in spring and summer. To ensure the presence of allergens in the environment, we collected BAL samples over a whole year.…”