Abstract
Perception of a chronic illness is a driver of patient behaviour that may impact treatment outcomes. The cross-sectional PETRA study was designed to describe the links between disease perception, patient behaviour and treatment outcomes in adults with allergic rhinitis (AR). Overall, 687 French general practitioners (GPs) included 1929 analysable patients (mean age: 39 years; intermittent/persistent symptoms: 46.2/52.3%). Of the patients, 14.1% had also been diagnosed with asthma; 71.7% had uncontrolled AR (ARCT score < 20), and 53.6% had a good perception of their illness (BIPQ score < 5). Factors significantly associated with poor perception of AR were ENT (ear/nose/throat) complications, nasal pruritus, uncontrolled AR and asthma. A strong negative correlation was observed between the BIPQ and ARCT scores: the poorer the patient’s perception, the less the AR was controlled. Although no causal relationship could be drawn, GP-driven improvement of AR perception could lead to better control of symptoms.
Highlights
According to the World Health Organization (WHO), chronic diseases are the leading cause of morbidity and mortality worldwide, accounting for 43% of the global burden of disease
The study data confirmed that disease control of patients managed in a primary care setting was poor (71.7% of patients), which is consistent with the results of another French cohort followed by GPs14
The main objectives of the PETRA study were to identify the factors associated with poor perception of allergic rhinitis (AR) and how perception relates to control
Summary
According to the World Health Organization (WHO), chronic diseases are the leading cause of morbidity and mortality worldwide, accounting for 43% of the global burden of disease (as per the 2002 report; 60% expected in 2020). Poor control of chronic diseases represents a public health burden and, patients need to be managed with the best evidence-based strategies possible, both at the patient and the community level. Control of a chronic disease requires that treatments be adjusted for individual comorbidities and risk factors, as per guidelines, as well as the patient’s personal involvement. The personal involvement of each patient is correlated with his/her perception of the disease and the associated treatments used for its control. Disease perception corresponds to cognitive and emotional representations of the illness and health threat, and encompasses several dimensions such as identity, consequences, cause, timeline, cure or control. It is possible to activate a virtuous circle where perception and control can be improved, as shown with asthma
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