Abstract
BackgroundThe affliction of allergic rhinitis (AR) has been trivialised in the past. Recent initiatives by the European Academy of Allergy & Clinical Immunology and by the EU parliament seek to rectify that situation. The aim of this study was to provide a comprehensive picture of the burden and unmet need of AR patients.MethodsThis was a cross-sectional, online, questionnaire-based study (June–July 2011) including symptomatic seasonal AR (SAR) patients (≥18 years) from a panel. SAR episode pattern, severity, medication/co-medication usage, residual symptoms on treatment, number of healthcare visits, absenteeism and presenteeism were collected.ResultsOne thousand patients were recruited (mild: n = 254; moderate/severe: n = 746). Patients with moderate/severe disease had significantly more symptomatic episodes/year (8.0 vs 6.0/year; p = 0.025) with longer episode-duration (12.5 vs 9.8 days; p = 0.0041) and more commonly used ≥2 AR therapies (70.5 vs 56.1 %; OR 1.87; p = 0.0001), looking for better and faster nasal and ocular symptom relief. The reported symptom burden was high irrespective of treatment, and significantly (p < 0.0001) higher in the moderate/severe group. Patients with moderate/severe AR were more likely to visit their GP (1.61 vs 1.19 times/year; OR: 1.49; p = 0.0061); due to dissatisfaction with therapy in 35.4 % of cases. Patients reported SAR-related absenteeism from work on 4.1 days/year (total cost to UK: £1.25 billion/year) and noted presenteeism for a mean of 37.7 days/year (vs 21.0 days/year; OR 1.71; p = 0.0048). Asthma co-morbid patients reported the need to increase their reliever- (1 in 2 patients) and controller-medication (1 in 5 patients) if they did not take their rhinitis medication.ConclusionsThis study differentiated between patients with mild and moderate/severe AR, demonstrating a burden of poorly controlled symptoms and high co-medication use. The deficiency in obtaining symptom control with what are currently considered firstline treatments suggests the need for a novel therapeutic approach.Electronic supplementary materialThe online version of this article (doi:10.1186/s13601-015-0083-6) contains supplementary material, which is available to authorized users.
Highlights
The affliction of allergic rhinitis (AR) has been trivialised in the past
(p < 0.001) more patients with moderate/severe disease were aware of their sensitizing allergen (Table 1)
This study provides a comprehensive view of the AR burden and unmet need in the UK
Summary
The affliction of allergic rhinitis (AR) has been trivialised in the past. Recent initiatives by the European Academy of Allergy & Clinical Immunology and by the EU parliament seek to rectify that situation. The burden of AR is being recognised both by the European Academy of Allergy & Clinical Immunology (EAACI) as well as at the EU parliament level, in order. AR imposes a high socioeconomic burden, in terms of indirect costs, including absenteeism and presenteeism (i.e. productivity loss or under-performance at work and school) [18,19,20,21]. It has been associated with poor asthma control; patients reporting severe rhinitis exhibit poorer asthma control than those with mild disease, with a negative impact equivalent to that of smoking [22]. Management is often complicated by polysensitization [13, 34], the presence of allergic and non-allergic disease in the same patient (i.e. mixed rhinitis) [35] and confounded by phenotypes such as severe chronic upper airway disease (SCUAD) [36]
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