A multiallergen and miniscreen can change primary care provider diagnosis and treatment of rhinitis

Abstract

A number of studies suggested that limited economical airborne allergy screening can successfully predict true respiratory allergy and be of use to primary care providers (PCPs) in improving the accuracy of their differential diagnosis and treatment of allergic rhinitis. More accurate diagnosis would lead to proper use of intranasal corticosteroids, intranasal antihistamines, and oral antihistamines. However, to date, there have been no reports of an actual application of the screens by PCPs. This study was designed to measure the potential impact of providing a limited multiallergen and miniscreen (MAMS) by in vitro allergy testing on PCP diagnosis and treatment of rhinitis, properly differentiating seasonal allergic rhinitis, perennial allergic rhinitis, vasomotor rhinitis, and mixed rhinitis. Two hundred adult and adolescent patients who presented to PCPs for rhinitis symptoms were enrolled from July to November of 2007. They signed informed consent and a serum specimen for MAMS was obtained. The PCPs answered a questionnaire concerning their diagnosis and treatment before and after the MAMS results were revealed to the PCP. The PCPs changed or modified the original diagnosis in 139 of 200 patients. Originally, 182 subjects had an allergic rhinitis diagnosis. After the results of the MAMS were known, 113 continued with an allergic rhinitis diagnosis. Vasomotor or nonallergic rhinitis diagnoses increased from 18 to 87 cases. Use of MAMS can help PCPs make a more accurate diagnosis and offer better therapy to patients with rhinitis.