Attitudes, practices on allergic rhinitis of generalists and specialists in Philippine National Capital Region

Abstract

BackgroundTreatment of allergic rhinitis (AR) consistent with consensus guidelines is reported to result in better patient outcomes. However, physicians may manage patients independently of guidelines. Asian data on physician perspectives regarding AR diagnosis and management is limited.ObjectiveThe study objective is to assess attitudes and practices on AR of Filipino specialists and generalists.MethodsA cross sectional survey of 100 specialists and 100 generalists was conducted from November 2014 to January 2015. A previously validated and pilot tested questionnaire was administered via structured face to face interviews.ResultsSpecialists reported greater adequate knowledge of AR (specialists, 58%; generalists, 39%) and adherence to guidelines (specialists, 84%; generalists, 54%). Diagnostic tests were not routinely used (specialists, 81%; generalists, 92%). Monotherapy, specifically antihistamines, was preferred for mild AR. For moderate-severe AR, preference for monotherapy versus combination therapy (specialists, 49% vs. 51%; generalists, 44% vs. 56%) was similar. Both groups preferred intranasal corticosteroid spray (INCS) for monotherapy and antileukotrienes, antihistamines, INCS for combination therapy. For adjuvant therapy, specialists (82%) preferred nasal irrigation/douche. Primary consideration for choice of therapy was efficacy. Cost was the perceived reason for patients' noncompliance with treatment.ConclusionDespite differences in awareness of and adherence to guidelines, prescribing patterns on management of mild and moderate-severe AR are similar among Filipino specialists and generalists. This can be attributed to a shared perception of efficacy and cost as drivers for therapeutic choices.

Attitudes, practices on allergic rhinitis of three socioeconomic classes of Filipinos in the National Capital Region

“…In a previous survey, general and specialist physicians in the Philippine NCR perceive cost to be the primary reason for noncompliance of patients with therapeutic regimens. Similarly, the finding of antihistamines as the most commonly used prescription drugs is also consistent with the same survey where antihistamines are reported as the preferred single drug treatment of Filipino physicians for mild or moderate-severe AR [ 22 ].…”

Primary care management of allergic rhinitis: A cross-sectional study in four ASEAN countries

“…The survey results demonstrated that antihistamines, particularly 2 nd generation antihistamines, are still the mainstay of AR treatment in primary care practice within Malaysia, Philippines, Thailand and Indonesia. This correlated with a survey from the Philippines [ 11 ] that assessed the specialists’ and GPs’ attitudes and practices followed for the treatment of the AR patients. The authors showed that monotherapy, mainly antihistamines, was the preferred choice for mild AR treatment.…”

“…For moderate-severe patients, both monotherapy (intranasal corticosteroid spray; INCS) and combination therapy with antileukotrienes, antihistamines, INCS were preferred. The choice of these therapeutic regimes was primarily attributed to efficacy and cost-effectiveness [ 11 ]. In contrast, the Current Allergic Rhinitis Experiences Survey (CARES) [ 16 ], which assessed the AR management practices followed by the primary healthcare professionals (HCPs) in the U.S., demonstrated that more than 80% of the HCPs stated intranasal corticosteroids as the gold standard for the treatment of AR.…”

“…The questionnaire for this study entitled ‘ASEAN Primary Care Survey for Allergy Rhinitis Care’ was designed, following previously conducted survey publications [ 8 , 10 , 11 ]. It consisted of 32 questions divided into five sections:…”

Great learning, much networking, and friendship

“…Readers of this journal will find the original articles on the treatment adherence and quality of life among adults with chronic urticaria in Singapore [ 3 ], and the attitudes, practices on allergic rhinitis of generalists and specialists in Philippine National Capital Region [ 4 ]. The readers will also find the first study on the pattern of anaphylaxis in Saudi Arabia [ 5 ] and the interleukin-10 and interleukin-5 balance in patients with active asthma, those in remission, and healthy controls from Japan, which showed a similar result from a murine asthma model of immunotherapy [ 6 ].…”