Burden Of Rhinitis Research Articles

Seasonal Allergic Rhinitis is Effectively Assuaged With an Essential Oil Inhaler (AromaStick®): Results From a Randomized, Controlled, Double-blind Effectiveness Trial

Background: There are effective pharmaceutical agents to treat seasonal allergic rhinitis, but more and more individuals resort to alternative forms of treatment. One possible alternative candidate is essential oils. Recently, an inhaler specifically designed to deliver essential oil scents has proven very effective in treating various medical parameters (e.g., blood pressure, heart rate, cortisol, blood oxygenation, or pain). </P><P> Objective: This work investigates whether an inhaler (AromaStick® ‘Nasal Fresh’) designed to clear the nasal passageway and reduce congestion has beneficial effects in individuals suffering from seasonal allergic rhinitis. Methods: A two-armed, randomized, controlled, double-blind effectiveness trial involving individuals with medium to strong symptoms was conducted to investigate the inhaler’s specific treatment effects. Results: Over a period of two weeks, the odor inhaler strongly reduced allergic symptoms for both overall AR symptomatology (d = 1.2) and individual symptomatic allergic rhinitis burden (d = 1.7). Conclusion: The inhaler produced strong symptom relief. Effects were largest in individuals suffering primarily from nasal symptoms.

The clinical burden of allergic rhinitis in five Middle Eastern countries: results of the SNAPSHOT program

BackgroundThe SNAPSHOT program provides current data on the allergic rhinitis burden in the adult general population of five Middle Eastern countries (Egypt, Turkey, Kuwait, Saudi Arabia and the United Arab Emirates, the latter three grouped into a Gulf cluster).MethodsA multi-country, cross-sectional, epidemiological program conducted by telephone in a random sample of the adult general population; quotas were defined per country demographics. Subjects were screened for allergic rhinitis using the Score For Allergic Rhinitis questionnaire. Current prevalence (last 12 months) was estimated. Disease severity and control were assessed using the Allergic Rhinitis and its Impact on Asthma classification and Rhinitis Control Assessment Test respectively. Quality of sleep, impact on daily activities and quality of life were measured using the Epworth Sleepiness Scale, Sheehan Disability Scale and EuroQol Five-Dimension questionnaire respectively. Multivariate logistic regression analyses were used to investigate risk factors and co-morbidities.Results1808 of 33,486 subjects enrolled in the SNAPSHOT program fulfilled the case definition for allergic rhinitis. Prevalence was 3.6% [95% CI 3.2–4.0%] in Egypt, 6.4% [95% CI 5.9–6.9%] in Turkey and 6.4% [95% CI 6.0–6.9%] in the Gulf cluster. Risk factors identified were country, co-morbid asthma and income. Subjects with allergic rhinitis reported a significantly lower quality of life compared to the general population (p < 0.0001). Overall, 55% of allergic rhinitis subjects were moderate/severe and 33% were uncontrolled. Both these groups reported impaired quality of life and quality of sleep and increased impairment of daily activities compared to mild/well-controlled subjects (p < 0.0001).ConclusionsAlthough the observed prevalence of allergic rhinitis in these Middle Eastern countries is low compared to western countries, its burden is considerable. Allergic rhinitis in general, and specifically uncontrolled and severe disease, results in a negative impact on quality of life, quality of sleep and daily activities.

The Burden of Rhinitis and the Impact of Medication Management within the Community Pharmacy Setting

The burden of rhinitis is high. It is unknown to what extent this burden is related to inappropriate medication use. This study aimed to identify the way in which people with rhinitis medicate their condition and to evaluate the appropriateness of this medication management. Pharmacy customers who visited Sydney metropolitan community pharmacies and purchased medication for nasal symptoms were the sampling frame for this study. To determine the condition for which the participants were seeking medication and the appropriateness of their medication selection, the following data were collected with a researcher-administered questionnaire: participant's demographics, symptoms, medication selected. An expert panel of clinical researcher pharmacists and specialist respiratory physician evaluated the appropriateness of medication selection based on the Allergic Rhinitis and its Impact on Asthma international guidelines. Two hundred and ninety-six participants were recruited from 8 pharmacies; 63.2% had a doctor's diagnosis for the symptoms for which they were selecting treatment. Seventy percent of participants self-selected their medications. Seventy-one percent of the participants were identified as having rhinitis. Overall, 16.5% of participants who had rhinitis selected optimal medications. Sixteen percent of participants with allergic rhinitis reported wheezing (6.3% selected optimal medications). The majority of the participants with rhinitis selected suboptimal medications from community pharmacy highlighting the significant burden of rhinitis in community pharmacy and the contribution of medication management. Pharmacists need to take a proactive and evidence-based role in the management of rhinitis supported by clinical pathways when need to be articulated and promoted in all rhinitis guidelines.

AB042. Allergy Working Group Update: the burden and management of rhinitis and rhinosinusitis in UK primary care

Background Rhinitis and rhinosinusitis are diseases of the upper airways with a high prevalence and when they are chronic with a high quality of life burden on patients and costs for society. To date, data on the primary care burden of rhinitis and rhinosinusitis are limited as is knowledge of how primary care physicians currently manage these patients. This study aims to quantify the burden of CRS and characterize related management approaches in UK primary care.

Rhinitis in Children: Current Aspects of Diagnosis and Treatment

The article is devoted to one of the most urgent problems of pediatrics — rhinitis in children. The difficulty of nasal breathing, being one of the most frequent complaints to pediatricians, can be caused by a banal respiratory infection, as well as be one of the systemic pathology’s symptoms. The economic burden of rhinitis is great for any health budget, the total direct and indirect costs are huge. The article shows the main phenotypic characteristics of rhinitis depending on the etiological factor; gives the modern principles of differential diagnostic search; points studies, use of which is not recommended in routine practice. The authors reflect the key components of a complex therapy and discuss in detail the tactics and possible pharmacological treatment strategies.

The Burden of Rhinitis and Rhinoconjunctivitis in Adolescents

PurposeRhinitis and conjunctivitis are common diseases worldwide that are frequently associated. Nevertheless, the risk factors for rhinoconjunctivitis are not well-described and the impact of conjunctivitis on rhinitis and asthma in children remains unknown. This study explored the different risk factors and evaluated the burden of rhinoconjunctivitis among adolescents.MethodsThis was a cross-sectional study conducted on a random sample of schoolchildren, aged 10-17 years, using skin prick tests and a self-administered questionnaire on respiratory health investigating the impact of rhinitis and rhinoconjunctivitis on daily activities.ResultsA complete evaluation was obtained for 2,150 children. The prevalence of rhinitis alone was 18.2% and rhinitis associated with conjunctivitis was 20.5%. Rhinoconjunctivitis was more frequently associated with females, a parental history of atopy, domestic exposure to mold/dampness, passive smoke exposure, and reported truck traffic in residential streets. Moreover, rhinoconjunctivitis was associated with a higher level of allergic sensitization. The prevalence of current asthma was 1.7% in subjects without rhinitis or rhinoconjunctivitis, 5.1% in rhinitis and 10.7% in rhinoconjunctivitis. In a logistic model, rhinoconjunctivitis yielded a 2-fold risk for current asthma with respect to rhinitis. Subjects with rhinoconjunctivitis had poorer quality of life (QoL); there was an impact on daily activities in 4.6% of rhinitis and 10.7% of rhinoconjunctivitis.ConclusionsOcular symptoms increase the role of rhinitis as a risk factor for asthma and its impact on daily activities in children.

Prevalence and burden of rhinitis and rhinoconjunctivitis in 9‐ to 11‐year‐old children

Methods This was a cross sectional study including a sample of children with 9 to 11 years of age, recruited from 40 randomly selected schools in Lisbon. The ISAAC phase II questionnaire, completed by caregivers, was used to collect data. It included questions on symptoms (wheezing, rhinitis and eczema), use of treatments and health services. Rhinitis ever was defined as the presence, ever, of at least one nasal symptom (sneezing, runny or blocked nose), in the absence of respiratory infection; CR was defined by the presence of rhinitis ever and at least one nasal symptom in the previous 12 months; if CR was accompanied by itchywatery eyes it was considered that the child had CRC.

Economic Impact of Treatments for Controlling Symptoms Associated with Rhinitis: an Evaluation of Narivent® vs Standard Therapy

Rationale and aim: Upper airway disorders, like allergic and non-allergic rhinitis, are common nasal conditions affecting millions of individuals worldwide. The prevalence of allergic rhinitis (AR), in particular, has been increasing in the last decades. The pervasiveness of this disorder therefore imposes a large burden both on individual patients and the society. A wide range of drugs exists for symptomatic treatment of rhinitis, such as corticosteroids, decongestants, and an- tihistamines, but standard therapies are often associated with several side effects. A new class of medical devices, based on bio-mechanically innovative triggers, has been proven to have a good clinical effectiveness with lower adverse reac- tions, particularly over prolonged administration periods. The present study aims at evaluating the economic impact of rhinitis, with respect to direct and indirect costs, and analys- ing the use of the medical device Narivent ® compared to standard therapies to manage the symptoms of this illness. Methods: Via a Monte Carlo simulation study, data on disease prevalence, drug prescription and cost of both the specific therapeutic approach and the adverse events treatment will be combined to provide an estimate of the overall cost of the pharmacotherapy as compared with Narivent ® . Results: Lowering the impact of adverse reactions related to standard therapy through the use of novel therapeutic ap- proaches like Narivent ® , might reduce the overall burden of rhinitis by about 5 billion per year. Conclusion: The use of the medical device Narivent ® , as an alternative approach to manage symptoms associated with rhinitis, may contribute to bring down its costs by about 3.5% yearly as compared to the standard therapy.

Sleep and allergic disease: A summary of the literature and future directions for research

Atopic diseases, such as asthma and allergic rhinitis, are common conditions that can influence sleep and subsequent daytime functioning. Children and patients with allergic conditions from ethnic minority groups might be particularly vulnerable to poor sleep and compromised daytime functioning because of the prevalence of these illnesses in these groups and the high level of morbidity. Research over the past 10 years has shed light on the pathophysiologic mechanisms (eg, inflammatory mediators) involved in many atopic diseases that can underlie sleep disruptions as a consequence of the presence of nocturnal symptoms. Associations between nocturnal symptoms and sleep and poorer quality of life as a result of missed sleep have been demonstrated across studies. Patients with severe illness and poor control appear to bear the most burden in terms of sleep impairment. Sleep-disordered breathing is also more common in patients with allergic diseases. Upper and lower airway resistance can increase the risk for sleep-disordered breathing events. In patients with allergic rhinitis, nasal congestion is a risk factor for apnea and snoring. Finally, consistent and appropriate use of medications can minimize nocturnal asthma or allergic symptoms that might disrupt sleep. Despite these advances, there is much room for improvement in this area. Asummary of the sleep and allergic disease literature is reviewed, with methodological, conceptual, and clinical suggestions presented for future research.

Epidemiology and Burden of Rhinitis and Rhinoconjunctivitis in 9- to 11-Year-Old Children

Rhinoconjunctivitis (RC) is regarded as the most common chronic disease of childhood; however, the currently available epidemiological studies on prevalence, burden, and risk factors of RC are insufficient. This analysis aimed to investigate potential risk factors, symptom frequency, and burden of RC. Using the International Study of Asthma and Allergies in Childhood Phase II questionnaires, 6963 elementary school children aged 9-11 years were surveyed in five different city centers of Turkey. All participants were skin-prick tested with common aeroallergens. The prevalence of ever rhinitis, physician-diagnosed rhinitis, current rhinitis, and current RC were 51.6, 31.0, 43.5, and 23.1%, respectively; 19.8% of children with RC symptoms were atopic to at least one allergen. Among students with RC symptoms, 42.2, 23.9, 35.8, and 28.2% reported moderate-severe interference of daily activities, at least 1 day of absence from school, visit to a health care professional, and any drug usage for rhinitis, respectively. Nasal decongestants and oral antihistamines were the most frequently used treatment. Approximately 70% of RC patients reported perennial symptoms and 42.8% were classified as mild to intermittent. Multivariate logistic regression analysis revealed family history of asthma and/or allergic rhinitis (odds ratio [OR] = 1.863; confidence interval, [CI] = 1.583-2.191; p < 0.001), living in a house with mold and dampness in the 1st year of life (OR = 1.651; CI = 1.356-2.01; p < 0.001), maternal smoking in pregnancy (OR = 1.425; CI = 1.089-1.864; p = 0.011), low monthly income (OR = 1.685; CI = 1.422-1.998; p = 0.001), current wheezing (OR = 2.543; CI = 2.151-3.006; p = 0.001), and current atopic eczema (OR = 2.503; CI = 1.96-3.196; p = 0.001) as significant risk factors for current RC. Along with the high prevalence of RC in childhood, underdiagnosis and undertreatment of the disease are also frequent. The socioeconomic burden of the disease can be reduced by increasing awareness and proper diagnosis/treatment.

Sleep, quality of life, and productivity impact of nasal symptoms in the United States: Findings from the Burden of Rhinitis in America survey

Rhinitis is a common chronic condition that has been shown in observational and interventional studies to have a substantial impact on the sufferer. This study was performed to describe the impact of symptoms of allergic rhinitis (AR) on sleep, quality of life, and productivity in a U.S. population. A cohort of AR sufferers and non-AR sufferers was assembled by screening a representative sample of 15,000 households with a self-administered questionnaire in January 2004. A subsample of respondents received a detailed follow-up questionnaire in the May/June pollen season. Of the 7024 individuals with complete data, 3831 met the case definition of AR sufferer; 3193 were non-AR sufferers. Overall, AR sufferers had consistently poorer average scores on the sleep, quality of life, cognition, and productivity scales compared with non-AR sufferers. Subjects with AR symptoms had more sleep impairment (51.2) compared with subjects with non-AR symptoms and those with no symptoms (59.8 and 63.3, respectively). Only 3.6% of subjects with AR symptoms experienced 100% sleep adequacy compared with 11.7% of subjects with non-AR symptoms and 19.2% of subjects with no symptoms. Quality of life and cognition scores were worse in subjects with AR symptoms compared with subjects with non-AR or no symptoms. Work and school productivity was significantly reduced in subjects with AR symptoms in the past 4 weeks compared with subjects with no symptoms (p < 0.05). Individuals who suffer from AR symptoms experience a substantial burden on their ability to sleep, quality of life, cognitive function, and school/workplace productivity.

Rhinitis symptoms and comorbidities in the United States: Burden of rhinitis in America survey

Rhinitis symptoms and comorbidities in the United States: Burden of rhinitis in America survey

The prevalence of nasal symptoms attributed to allergies in the United States: Findings from the burden of rhinitis in an America survey

Although the annual prevalence of physician-diagnosed hay fever has been previously reported, the prevalence of allergic rhinitis symptoms in the United States is uncertain. The purpose of this study was to estimate the prevalence of allergic rhinitis symptoms in the United States. A self-administered 10-item screening questionnaire regarding nasal symptoms was sent to representative households in the United States in January 2004. A total of 8,708 members (44.3%) reported nasal symptoms on > or =7 days in the past 12 months. The majority of these responders described their symptoms as seasonal or perennial allergies (n = 5,944) compared with cold or flu only (n = 1,841), cold or flu and vasomotor rhinitis (n = 175), or vasomotor rhinitis only (n = 748). The prevalence of self-reported seasonal and perennial allergic rhinitis symptoms on > or =7 days in the past 12 months was 30.2%, which corresponds to 89.6 million persons in the United States. The prevalence of self-reported physician-diagnosed seasonal or perennial allergic rhinitis with symptoms on > or =7 days was 22%, or approximately 65 million persons nationwide. Among responders with a higher burden of nasal symptoms (> or =30 days), the prevalence of physician-diagnosed hay fever, allergic rhinitis, or nasal allergies was 11.9% of the total population. The prevalence of nasal symptoms attributed to rhinitis related to seasonal and perennial allergies in the United States ranged between 11.9 and 30.2% depending on duration of symptoms and physician diagnosis. Almost one-half of Americans experience troublesome nasal symptoms on at least 7 days throughout the year, with most attributing their symptoms to allergies.

The burden of rhinitis in a managed care organization

Rhinitis is a common health condition, but the extent of the burden in managed care organizations (MCOs) has not been well described. To compare medical utilization in a large MCO of patients (1) with vs without rhinitis and (2) with allergic (AR) vs nonallergic (NAR) rhinitis. Patients 4 years and older with 1 or more encounters with an International Classification of Diseases, Ninth Revision, code for rhinitis and patients treated for rhinitis but without a rhinitis encounter (rhinitis treatment-only group) were identified. Patients seen in allergy departments for rhinitis were categorized as having AR or NAR. Of 1,726,084 patients continuously enrolled for all 4 study years, 29% had 1 or more encounters for rhinitis (15%) or were treated for rhinitis (14%). Compared with patients without rhinitis, those with rhinitis encounters were significantly more likely to have encounters for asthma (odds ratio [OR], 2.7), acute sinusitis (OR, 4.4), chronic sinusitis (OR, 15.2), conjunctivitis (OR, 1.5), acute otitis media (OR, 1.9), chronic otitis media (OR, 4.3), sleep apnea (OR, 3.4), and fatigue (OR, 2.0). Results for rhinitis treatment-only patients (n = 242,565) were generally similar to those for rhinitis encounter patients. NAR was diagnosed in 21% of patients, who were significantly more likely than patients with AR to undergo sinus radiology and nasal surgery; to receive diagnoses of sinusitis, otitis media, sleep apnea, and fatigue; and to receive medications for nonrespiratory conditions (P < .001). Rhinitis was common in this large MCO. Patients with rhinitis, especially NAR, had significantly more respiratory and nonrespiratory comorbid conditions than did patients without rhinitis.

The Burden Of Rhinitis In A Managed Care Organization (MCO)

The Burden Of Rhinitis In A Managed Care Organization (MCO)

Nighttime Symptoms Score Provides Clinically Relevant Measure of Allergic Rhinitis Burden

Nighttime Symptoms Score Provides Clinically Relevant Measure of Allergic Rhinitis Burden

The burden of rhinitis in children with asthma

The burden of rhinitis in children with asthma

Burden of rhinitis in children with asthma

Although the clinical association of allergic rhinitis and asthma has been recognized for centuries, in recent years the association appears to be stronger than was reported previously. However, data for children are less clear, and some studies indicate that results observed in developing countries may differ from those observed in Western populations. We therefore intended to document the association of rhinitis with pediatric asthma in terms of caregivers' perception, physician practice, and file records. Asthmatic children aged 3-16 years with at least 1-year follow-up in an allergy-asthma outpatient clinic were invited to participate in the study during a 10-month interval. In addition to a face-to-face questionnaire-based interview, file records were evaluated retrospectively to obtain information relating to asthma and rhinitis. Of 396 patients included in the study, 369 with consistent replies were included in the analyses. The mean age of the study group was 10.6 +/- 0.2 (mean +/- SEM) years, and a greater proportion of the respondents were male (63.7%), atopic (78.3%), and mildly asthmatic (50.7%). House dust mite and grass pollens were the most commonly sensitized allergens (50.7% and 46.9%, respectively). Although only 5.4% of our study population regarded themselves as rhinitic and 23.8% had been diagnosed with allergic rhinitis according to the file records, almost 57.7% of patients had required medications for rhinitis within the last year, and 68.8% had findings consistent with allergic rhinitis. Furthermore, 41.2% and 58.8% reported that their rhinitis symptoms caused a significant burden in their daily life and exacerbated their asthma, respectively, and almost 50% felt that their rhinitis had not been given significant consideration by their physician. In conclusion, although we report a large discrepancy between caregivers' perception of rhinitis, documentation in file records, and treatments for rhinitis, the allergic rhinitis prevalence determined in the survey and the medication use for rhinitis appeared to be in agreement. We recommend a greater effort be made to identify, label, and educate children with rhinitis and their families in asthma outpatient clinics.

Prevalence and economic burden of rhinitis in patients treated for asthma

Prevalence and economic burden of rhinitis in patients treated for asthma