Abstract
Allergic rhinitis (AR) is increasingly becoming a patient self-managed disease. Just under 70% of patients purchasing pharmacotherapy self-select their treatment with no health-care professional intervention often resulting in poor choices, leading to suboptimal management and increased burden of AR on the individual and the community. However, no decision is made without external, influencing forces. This study aims to determine the key influences driving patients’ decision-making around AR management. To accomplish this aim, we utilised a social network theory framework to map the patient’s AR network and identify the strength of the influences within this network. Adults who reported having AR were interviewed and completed an AR network map and AR severity and quality of life questionnaires. Forty one people with AR completed the study. The AR networks of the participants had a range of 1–11 influences (alters), with an average number of 4 and a median of 5. The larger the impact of AR on their quality of life, the greater the number of alters within their network. The three most commonly identified alters were, general practitioners, pharmacists and the participants’ ‘own experience’. The strength of the influence of health-care professionals (HCPs) was varied. The proportion of HCPs within the AR network increased as the impact of AR on their quality of life increased. By mapping the AR network, this study demonstrated that there are multiple influences behind patient’s decisions regarding AR management but the role of the HCP cannot be dismissed.
Highlights
Allergic rhinitis (AR) is a chronic respiratory condition that is globally increasing in prevalence and receiving worldwide recognition for the burden associated with its suboptimal control.[1,2] The seemingly innocuous symptoms of AR, which include sneezing, rhinorrhoea, nasal congestion and watery/itchy eyes, can significantly impair an individual’s quality of sleep, concentration and ability to perform their daily activities.[3]
There are several factors that contribute to AR being a challenging condition to manage including, miscommunication between health-care professionals (HCPs) and patients about concept of AR control, the co-existence of non-AR and the suboptimal use of medicines leading to inadequate symptom relief.[2,8,9,10]
Where AR management has traditionally been the domain of primary HCPs such as general practitioners (GPs) and pharmacists,[11,12,13,14] the availability of medicines for purchase without consulting HCPs has contributed to AR management becoming patient driven.[15]
Summary
Allergic rhinitis (AR) is a chronic respiratory condition that is globally increasing in prevalence and receiving worldwide recognition for the burden associated with its suboptimal control.[1,2] The seemingly innocuous symptoms of AR, which include sneezing, rhinorrhoea, nasal congestion and watery/itchy eyes, can significantly impair an individual’s quality of sleep, concentration and ability to perform their daily activities.[3]. There are several factors that contribute to AR being a challenging condition to manage including, miscommunication between health-care professionals (HCPs) and patients about concept of AR control, the co-existence of non-AR and the suboptimal use of medicines leading to inadequate symptom relief.[2,8,9,10] Where AR management has traditionally been the domain of primary HCPs such as general practitioners (GPs) and pharmacists,[11,12,13,14] the availability of medicines for purchase without consulting HCPs has contributed to AR management becoming patient driven.[15] A particular factor that has significant impact on AR management is the high level of patient selfselection of medications. Recent Australian research has demonstrated that just under 70% of pharmacy customers purchased a treatment for AR symptoms by self-selecting their treatment without consulting a HCP, only 15% selecting optimal treatment for their symptoms.[15]
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