Identifying the hidden burden of allergic rhinitis (AR) in community pharmacy: a global phenomenon

Abstract

BackgroundPatients with allergic rhinitis often trivialise their condition, self-manage inappropriately, and would benefit from health care intervention. The primary point of health care contact for these self-managing allergic rhinitis patients is the community pharmacy. With the majority of allergic rhinitis treatments being available for purchase over the counter, without health care professional contact, we know little about how the patients self-manage. This study aims to identify the burden of allergic rhinitis in the community pharmacy and to identify key opportunity for intervention.MethodsPharmacy customers, who purchased nasal treatment in a community pharmacy, were approached with a research-administered questionnaire that collected data on medical history, symptoms and products purchased for the treatment of nasal symptoms.ResultsOf the 296 participants, 69.9% self-managed with over-the-counter medications; with 68% experiencing allergic rhinitis symptoms and only 44.3% of this subgroup had a doctor’s diagnosis. Nasal congestion (73.6%) was most commonly experienced and oral antihistamines were most commonly purchased (44.3%), indicating a pattern of suboptimal management. A third of participants (36.5%) experienced moderate-severe symptoms, persistently, which impacted on their daily living. Medication selection was mainly based on pharmacy customers’ perceptions of medication effectiveness (47.6%).ConclusionA majority of participants that self-selected over-the-counter medications have symptoms consistent with allergic rhinitis, with almost half not having received a diagnosis. Medication purchasing patterns suggest that sub-optimal therapeutic decisions made by participants, even when they are experiencing significant symptoms. This study uncovers the hidden burden of allergic rhinitis in the community pharmacy and a missed opportunity to intervene and refer if necessary. Patients need to be guided through appropriate treatment as this study showed that many should be referred to a medical practitioner.Electronic supplementary materialThe online version of this article (10.1186/s40733-017-0036-z) contains supplementary material, which is available to authorized users.

Mobile technology offers novel insights into the control and treatment of allergic rhinitis: The MASK study

“…5 Patients are poorly adherent to treatment and often selfmedicate. 6,7 They want more effective and fast-acting treatments. Therefore observational real-life studies are needed to complement RCTs to better understand the efficacy of INCScontaining medications because RCTs do not select patients and report their behavior.…”

ARIA pharmacy 2018 “Allergic rhinitis care pathways for community pharmacy”

“…In fact, many patients with AR under‐recognize their condition and, as such, do not even consult a physician . A large proportion of AR patients actually self‐manage their condition, and the pharmacist is often the first HCP to whom a person with nasal symptoms presents . This further strengthens the important role of pharmacists within multidisciplinary healthcare teams, acting at different steps of the ARIA‐pharmacy ICPs …”

“…Allergic diseases such as rhinitis and asthma are common, complex conditions, associated with allergen‐specific IgE and nonallergic mechanisms . These diseases represent an enormous burden associated with personal, medical, and social costs as well as impairment in work productivity, impacting health and social inequalities in all age‐groups …”

Mobile Technology in Allergic Rhinitis: Evolution in Management or Revolution in Health and Care?

“…Jean Bousquet, MD (1-3), Ignacio J Ansotegui, MD (4), Josep M Anto, PhD (5)(6)(7)(8), Sylvie Arnavielhe, PhD (9), Claus Bachert, MD (10), Xavier Basagaña, PhD (5,7,8), Annabelle Bédard, PhD (5,7,8), Anna Bedbrook, BSc (2), Matteo Bonini, MD (11), Sinthia Bosnic-Anticevich, PhD (12), Fulvio Braido, MD (13), Vicky Cardona, MD (14), Wienczyslawa Czarlewski, MD (15), Alvaro A Cruz, MD (16), Pascal Demoly, MD (17)(18), Govert De Vries, MSc (19), Stephanie Dramburg, MD (47), Eve Mathieu-Dupas, PhD (9), Marina Erhola, PhD (20), Wytske J Fokkens, MD (21), Joao A Fonseca, MD (22), Tari Haahtela, MD (23), Peter W Hellings, MD (24), Maddalena Illario, MD (25), Juan Carlos Ivancevich, MD (26), Vesa Jormanainen, MD (20), Ludger Klimek, MD (27), Piotr Kuna, MD (28), Violeta Kvedariene, MD (29), Daniel Laune, PhD (9), Désirée Larenas-Linnemann, MD (30), Olga Lourenço, PhD (31), Gabrielle L Onorato, MSc (2), Paolo M Matricardi, MD (32), Erik Melén, MD (33), Joaquim Mullol, MD (34), Nikos G Papa...…”

“…For example, children with moderate-severe seasonal allergic rhinitis, treated with daily mometasone, improved their disease knowledge thanks to daily informative messages sent by their e-Diary app (42). If patients are seeking an approach involving the minimal interaction with health care professionals in AR management (47), it is then crucial that the mHealth app is in line with evidence-based essential self-management principles. A was recently designed and used to evaluate AR in order to support patients choosing an mHealth app and physicians recommending it (42).…”