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

Su, Nan; Lin, Jiangtao; Liu, Guoliang; Yin, Kai; Zhou, Xin; Shen, Huahao; Chen, Ping; Chen, Rongchang; Liu, Chun‐Tao; Wu, Changgui; Zhao, Jianping; Lin, Yanping

doi:10.1002/alr.21449

Cited by 6 publications

(6 citation statements)

References 30 publications

(46 reference statements)

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“…To be exact, a cross-sectional, hospital-based survey of 1,931 AR patients in two modernized cities (Guangzhou and Zhuhai) in Southern China and the prevalence of concomitant asthma for AR patients is 5.33% (103 of 1,931) 25. Comparatively, another cross-sectional questionnaire study surveyed the diagnostic methods and treatment patterns for asthma-AR comorbidity by primary respiratory medicine specialty (PRMs) from 98 hospitals across China and the PRMs reported an estimated prevalence of asthma-AR comorbidity of > 30% at their clinics 26. On the contrary, research conducted on 20,051 patients with asthma in an outpatient setting covering all territories of China confirmed that AR presented in 69.9% of patients with asthma,27 further suggesting the upper and lower airway relationship between AR and asthma.…”

Section: Current Status Of Comorbid Allergic Diseasesmentioning

confidence: 99%

“…For example, optimized instruments based on objective tests have been more adequately employed to assess the prevalence of AR in the past 5 years than before. Meanwhile, the definition of PRMs has been given great attention because PRMs with greater work experience and higher professional titles estimated treating a significantly higher proportion of patients with AR as well as asthma-AR comorbidity 26. Moreover, allergy specialists in China have confirmed that the incidence of pollen-, dust mites- and mold-sensitive AR can be predicted by employing models based on prevailing meteorological conditions,70 providing critical methods for the prevention of environmental exposure.…”

Section: Prospectsmentioning

confidence: 99%

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Increasing Prevalence of Allergic Rhinitis in China

Zhang

2019

Allergy Asthma Immunol Res

175

111

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Allergic rhinitis (AR) is a critical public health, medical and economic problem in China. AR is also an important risk factor which will cause many diseases or disorders, especially in children. The trend of AR incidence is still on the rise in recent years and has had a significant effect on the general public. This significant increase is alarming, which highlights an urgent need for better understanding of the prevalence status and characteristics, sensitization patterns, and the associated risk factors of AR in order to improve treatment and develop effective prevention strategies.

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Section: Current Status Of Comorbid Allergic Diseasesmentioning

confidence: 99%

Section: Prospectsmentioning

confidence: 99%

Increasing Prevalence of Allergic Rhinitis in China

Zhang

2019

Allergy Asthma Immunol Res

175

111

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“…Previously, the Asthma Insights and Managements surveys reported an underuse of ICS to treat asthma together with an overuse of oral steroids in the Asia-Pacific region compared with the US, Canada, and Europe 23. Knowledge gaps in the management of coexistent asthma-AR were also highlighted in a recent cross-sectional survey of physicians in China, in which a fifth of those surveyed reported the use of oral leukotriene antagonists as the most commonly used drug for treating AR while also controlling asthma 24…”

Section: Introductionmentioning

confidence: 99%

Asia-Pacific Survey of Physicians on Asthma and Allergic Rhinitis (ASPAIR): physician beliefs and practices about diagnosis, assessment, and treatment of coexistent disease

Aggarwal¹,

Shantakumar²,

Hinds³

et al. 2018

JAA

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BackgroundAsthma and allergic rhinitis (AR) frequently coexist, and having both asthma and AR is associated with uncontrolled asthma and a heavier disease burden. The Asia-Pacific Survey of Physicians on Asthma and Allergic Rhinitis (ASPAIR) aimed to assess physicians’ perceptions and their management practices for patients with coexistent disease.Materials and methodsA total of 1,204 general physicians and pediatricians from six countries in Asia, who routinely treat asthma patients, were interviewed in-person. Physicians were questioned about their attitudes and beliefs of coexistent asthma-AR, how they diagnose and treat patients, and their knowledge of international guideline recommendations.ResultsPhysicians reported that 45% of their patients with asthma have coexistent AR and 37% of their patients with AR have coexistent asthma. Most physicians (77%) agreed that coexistent asthma-AR is a genuine condition and that patients suffer worse symptoms with both the conditions vs one alone (86%). Although nearly all agreed that both asthma and AR should be treated (91%) and that intranasal (INS) and inhaled corticosteroids (ICS) could be given concurrently to these patients, 40% also thought that treating both conditions effectively at the same time is difficult, and approximately a quarter believed that corticosteroid therapy should be delayed in children for both asthma and AR. While there was universal recognition and acceptance that guidelines provide sufficient information for treating uncontrolled coexistent disease (≥80% physicians in all countries), physicians revealed that 41% of their asthma patients are treated with short-acting rescue medications alone, and only 47% responded that treatment with concurrent INS and ICS, as recommended in the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines, was their preferred treatment for coexistent disease.ConclusionThe ASPAIR survey demonstrates a widespread acceptance of coexistent asthma-AR, and the associated burden, but highlights the need for increased healthcare practitioner communication and awareness to improve appropriate treatment and management of these coexistent conditions.

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“…The main factor influencing treatment choice in this survey for both GPs and pediatricians was reported to be AR guidelines (in 86% of interviewed physicians) which contrasts from a survey in 1,200 primary care practitioners in Australia, Brazil, Canada, France, Germany, Italy, Spain and the UK, where only 3% of them reported to follow the AR guidelines, and 27% acknowledged that they adapted their management based on AR guidelines for individual patient treatment [4]. From a survey in China, respiratory medicine specialists had high-level knowledge of asthma management (>90%) but there were areas identified for improvement in their perception of AR and coexistent asthma [21]. Beside patient affordability, and drug availability, patient preference is an important factor influencing treatment choice.…”

Section: Discussionmentioning

confidence: 99%

A survey of management practices in coexistent allergic rhinitis and asthma (Asia-pacific Survey of Physicians on Asthma and allergic Rhinitis): results from Thailand

Bunupuradah¹,

Siriaksorn²,

Hinds³

et al. 2019

Asia Pacific Allergy

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Background Underdiagnosis and undertreatment of allergic rhinitis (AR) in patients with asthma can worsen treatment outcomes. There is limited evidence of clinical practices for management of coexistent AR-asthma in Thailand. Methods A multicountry, cross-sectional study (Asia-pacific Survey of Physicians on Asthma and allergic Rhinitis) to evaluate physician perceptions and management practices related to AR-asthma overlap in 6 Asian countries was conducted. For Thailand specifically, AR-asthma linkage questionnaires were developed and translated to Thailaland. General physicians (GPs) or pediatricians, randomly selected from hospitals in urban cities, routinely treating > 10 asthma patients/month were interviewed. Here we present the results for Thailand. Results Two hundred physicians (100 GPs and 100 pediatricians), of whom 70% worked in government hospitals, were interviewed. In their experience, 50% of asthma patients had AR and 28% of AR patients had asthma. Among diagnosed asthma patients, 65% of physicians routinely asked for any AR symptoms at every visit. Among diagnosed AR patients, 63% of physicians routinely asked for any asthma symptoms at every visit. In patients with coexisting AR-asthma, 91% of physicians treated both diseases simultaneously, while 6% of physicians treated asthma as a chronic disease but managed AR symptomatically. The most preferred treatment options for patients with AR-asthma were inhaled corticosteroids with intranasal steroids (46% in GPs, 71% in pediatricians). Conclusion The physicians interviewed in Thailand are aware about coexistent asthma-AR. There is a need to increase the awareness further for coexistent AR-asthma and to educate nonspecialist physicians in the proper management of AR-asthma patients.

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

Cited by 6 publications

References 30 publications

Increasing Prevalence of Allergic Rhinitis in China

Increasing Prevalence of Allergic Rhinitis in China

Asia-Pacific Survey of Physicians on Asthma and Allergic Rhinitis (ASPAIR): physician beliefs and practices about diagnosis, assessment, and treatment of coexistent disease

A survey of management practices in coexistent allergic rhinitis and asthma (Asia-pacific Survey of Physicians on Asthma and allergic Rhinitis): results from Thailand

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