Impact of allergic rhinitis on the day-to-day lives of children: insights from an Australian cross-sectional study

Abstract

Study design and objectiveCross-sectional, observational survey to describe the impact of allergic rhinitis (AR) on Australian children (2 to 15 years).MethodsParticipants (n=1541), parents of children aged 2 to 15 years, provided information on behalf of themselves and one eligible child in their household using a custom-built online questionnaire. Children were allocated to case (AR) or control (No AR) analysis groups based on a validated screening questionnaire.Statistical methodsThe study sample was stratified on age: primary analysis population (6 to 15 years, n=1111; AR=797, No AR=314); exploratory population (2 to 5 years). The primary endpoint, parent-perceived burden, was quantified using a validated measure of health status and analysed via comparison of means.ResultsThe majority of AR cases were treated (730/797; 90.3%) and classified as having moderate-severe, intermittent AR (549/797; 68.9%). Half reported adequate symptom control in the prior 2 weeks (389/797; 48.8%; OR=4.04; 95% CI (CI) 2.24 to 7.31). Having AR was associated with worse overall health status (7.4 vs 8.4, mean difference (least squares mean difference (LSMD))=−0.99; 95% CI −1.18 to −0.79), fewer days being happy (22.2 vs 25.9, LSMD=−3.68; 95% CI −4.82 to −2.54) and more days of poor physical (2.82 vs 0.78, LSMD=2.04; 95% CI 1.61 to 2.47) and emotional (2.14 vs 0.67, LSMD=1.47; 95% CI 1.02 to −1.92) health compared with not having AR. All of these outcomes were significantly (p<0.05) worse in children who reported inadequate symptom control. Having AR negatively impacted on schoolwork, sleep and other activities, and increased the likelihood of having comorbidities.ConclusionThe parent-perceived burden of AR in Australian children is high and it impacts many areas of day-to-day living. Inadequate symptom control is a key driver of the extent of this impact. Opportunities to optimise the management of AR in children include the adoption of self-assessment tools to gauge and monitor adequacy of symptom control.

International consensus statement on allergy and rhinology: Allergic rhinitis – 2023

“…As expected, these studies show impacts on QOL in this population. More surprisingly, they show impacts on parental QOL as well 1064–1067 . In one study, parents overestimate their children's QOL 1068 .…”

Impact of comorbid allergic diseases on health‐related quality of life of Hong Kong schoolchildren

“…Compared with nonasthmatic children, children with asthma scored lower on physical and emotional functioning, but not on social functioning 10,11 . Poorer emotional and physical outcomes were also observed in children with allergic rhinitis 12 …”

“…10,11 Poorer emotional and physical outcomes were also observed in children with allergic rhinitis. 12 Although the impact on HRQOL has been studied extensively, studies have mainly focused on children diagnosed with a single allergic disease. Recent research has found that multiple chronic health conditions are correlated with internalizing symptoms such as anxiety and depression in children.…”

Quantifying the benefits of early sublingual allergen immunotherapy tablet initiation in children

“…Allergic rhinitis (AR) is a highly prevalent chronic disease that causes symptoms in the upper airway (e.g. nasal pruritus and congestion, sneezing) and red itchy eyes, resulting in physical discomfort, sleep disturbances, impaired school performance, lower work productivity and in general an impaired quality of life (QoL) 1–6 . AR is recognized as a major risk factor for the development of allergic asthma (AA) 7,8 .…”