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Clinical and Translational Allergy
Published in: Clinical and Translational Allergy 1/2015

Open Access 01-12-2015 | Research

The hidden burden of adult allergic rhinitis: UK healthcare resource utilisation survey

Authors: David Price, Glenis Scadding, Dermot Ryan, Claus Bachert, G. Walter Canonica, Joaquim Mullol, Ludger Klimek, Richard Pitman, Sarah Acaster, Ruth Murray, Jean Bousquet

Published in: Clinical and Translational Allergy | Issue 1/2015

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Abstract

Background

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 aim of this study was to provide a comprehensive picture of the burden and unmet need of AR patients.

Methods

This 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.

Results

One 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.

Conclusions

This 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.
Appendix
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Literature
1.
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. Allergic Rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008;63(Suppl 86):8–160.CrossRefPubMed
2.
Canonica GW, Bousquet J, Mullol J, Scadding GK, Virchow JC. A survey of the burden of allergic rhinitis in Europe. Allergy. 2007;62(Suppl 85):17–25.CrossRefPubMed
3.
Mullol J. A survey of the burden of allergic rhinitis in Spain. J Investig Allergol Clin Immunol. 2009;19:27–34.PubMed
4.
Bousquet PJ, Demoly P, Devillier P, Mesbah K, Bousquet J. Impact of allergic rhinitis symptoms on quality of life in primary care. Int Arch Allergy Immunol. 2013;160:393–400.CrossRefPubMed
5.
Canonica GW, Mullol J, Pradalier A, Didier A. Patient perceptions of allergic rhinitis and quality of life: findings from a survey conducted in europe and the United States. World Allergy Organ J. 2008;1:138–44.PubMedCentralCrossRefPubMed
6.
Meltzer EO, Gross GN, Katial R, Storms WW. Allergic rhinitis substantially impacts patient quality of life: findings from the Nasal Allergy Survey Assessing Limitations. J Fam Pract. 2012;61:S5–10.PubMed
7.
8.
9.
Antonescu E, Childres N, Gardini E, Grossetete F, Juvin P, Parvanova A, et al. Written declaration on recognising the burden of allergic disease. European Parliament. http://​www.​eaaci.​org. Accessed June 2015.
10.
Samolinski B, Fronczak A, Kuna P, Akdis CA, Anto JM, Bialoszewski AZ, et al. Prevention and control of childhood asthma and allergy in the EU from the public health point of view: Polish Presidency of the European Union. Allergy. 2012;67:726–31.PubMedCentralCrossRefPubMed
11.
Bousquet J, Addis A, Adcock I, Agache I, Agusti A, Alonso A, et al. Integrated care pathways for airway diseases (AIRWAYS-ICPs). Eur Respir J. 2014;44:304–23.CrossRefPubMed
12.
Bousquet J, Michel J, Standberg T, Crooks G, Iakovidis I, Gomez M. The European Innovation Partnership on Active and Healthy Aging: the European Geriatric Medicine introduces the EIP on AHA Column. Eur Geriatr Med. 2014;5:361–2.CrossRef
13.
Valovirta E, Myrseth SE, Palkonen S. The voice of the patients: allergic rhinitis is not a trivial disease. Curr Opin Allergy Clin Immunol. 2008;8:1–9.CrossRefPubMed
14.
Kremer B, den Hartog HM, Jolles J. Relationship between allergic rhinitis, disturbed cognitive functions and psychological well-being. Clin Exp Allergy. 2002;32:1310–5.CrossRefPubMed
15.
Braido F, Baiardini I, Scichilone N, Musarra A, Menoni S, Ridolo E, et al. Illness perception, mood and coping strategies in allergic rhinitis: are there differences among ARIA classes of severity? Rhinology. 2014;52:66–71.PubMed
16.
Green RJ, Davis G, Price D. Concerns of patients with allergic rhinitis: the Allergic Rhinitis Care Programme in South Africa. Prim Care Respir J. 2007;16:299–303.CrossRefPubMed
17.
Mullol J, Bartra J, del CA, Izquierdo I, Munoz-Cano R, Valero A. Specialist-based treatment reduces the severity of allergic rhinitis. Clin Exp Allergy. 2013;43:723–9.CrossRefPubMed
18.
Lamb CE, Ratner PH, Johnson CE, Ambegaonkar AJ, Joshi AV, Day D, et al. Economic impact of workplace productivity losses due to allergic rhinitis compared with select medical conditions in the United States from an employer perspective. Curr Med Res Opin. 2006;22:1203–10.CrossRefPubMed
19.
Hellgren J, Cervin A, Nordling S, Bergman A, Cardell LO. Allergic rhinitis and the common cold–high cost to society. Allergy. 2010;65:776–83.CrossRefPubMed
20.
Small M, Piercy J, Demoly P, Marsden H. Burden of illness and quality of life in patients being treated for seasonal allergic rhinitis: a cohort survey. Clin Transl Allergy. 2013;3:33.PubMedCentralCrossRefPubMed
21.
Walker S, Khan-Wasti S, Fletcher M, Cullinan P, Harris J, Sheikh A. Seasonal allergic rhinitis is associated with a detrimental effect on examination performance in United Kingdom teenagers: case-control study. J Allergy Clin Immunol. 2007;120:381–7.CrossRefPubMed
22.
Clatworthy J, Price D, Ryan D, Haughney J, Horne R. The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control. Prim Care Respir J. 2009;18:300–5.CrossRefPubMed
23.
Schatz M. A survey of the burden of allergic rhinitis in the USA. Allergy. 2007;62(Suppl 85):9–16.CrossRefPubMed
24.
Bousquet J, Annesi-Maesano I, Carat F, Leger D, Rugina M, Pribil C, et al. Characteristics of intermittent and persistent allergic rhinitis: DREAMS study group. Clin Exp Allergy. 2005;35:728–32.CrossRefPubMed
25.
Bachert C, Van CP, Olbrecht J, van SJ. Prevalence, classification and perception of allergic and nonallergic rhinitis in Belgium. Allergy. 2006;61:693–8.CrossRefPubMed
26.
Demoly P, Allaert FA, Lecasble M. ERASM, a pharmacoepidemiologic survey on management of intermittent allergic rhinitis in every day general medical practice in France. Allergy. 2002;57:546–54.CrossRefPubMed
27.
Navarro A, Valero A, Rosales MJ, Mullol J. Clinical use of oral antihistamines and intranasal corticosteroids in patients with allergic rhinitis. J Investig Allergol Clin Immunol. 2011;21:363–9.PubMed
28.
Anolik R, Mometasone Furoate Nasal Spray With Loratadine Study Group. Clinical benefits of combination treatment with mometasone furoate nasal spray and loratadine vs monotherapy with mometasone furoate in the treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2008;100:264–71.CrossRefPubMed
29.
Ratner PH, van Bavel JH, Martin BG, Hampel FC Jr, Howland WC III, Rogenes PR, et al. A comparison of the efficacy of fluticasone propionate aqueous nasal spray and loratadine, alone and in combination, for the treatment of seasonal allergic rhinitis. J Fam Pract. 1998;47:118–25.PubMed
30.
Esteitie R, deTineo M, Naclerio RM, Baroody FM. Effect of the addition of montelukast to fluticasone propionate for the treatment of perennial allergic rhinitis. Ann Allergy Asthma Immunol. 2010;105:155–61.CrossRefPubMed
31.
Hellings PW, Dobbels F, Denhaerynck K, Piessens M, Ceuppens JL, De GS. Explorative study on patient’s perceived knowledge level, expectations, preferences and fear of side effects for treatment for allergic rhinitis. Clin Transl Allergy. 2012;2:9.PubMedCentralCrossRefPubMed
32.
Ciprandi G, Incorvaia C, Scurati S, Puccinelli P, Soffia S, Frati F, et al. Patient-related factors in rhinitis and asthma: the satisfaction with allergy treatment survey. Curr Med Res Opin. 2011;27:1005–11.CrossRefPubMed
33.
Valovirta E, Ryan D. Patient adherence to allergic rhinitis treatment: results from patient surveys. Medscape J Med. 2008;10:247.PubMedCentralPubMed
34.
Mosges R, Klimek L. Today’s allergic rhinitis patients are different: new factors that may play a role. Allergy. 2007;62:969–75.CrossRefPubMed
35.
Settipane RA, Lieberman P. Update on nonallergic rhinitis. Ann Allergy Asthma Immunol. 2001;86:494–507.CrossRefPubMed
36.
Bousquet PJ, Bachert C, Canonica GW, Casale TB, Mullol J, Klossek JM, et al. Uncontrolled allergic rhinitis during treatment and its impact on quality of life: a cluster randomized trial. J Allergy Clin Immunol. 2010;126:666–8.CrossRefPubMed
37.
Meltzer EO, Blaiss MS, Derebery MJ, Mahr TA, Gordon BR, Sheth KK, et al. Burden of allergic rhinitis: results from the Pediatric Allergies in America survey. J Allergy Clin Immunol. 2009;124:S43–70.CrossRefPubMed
38.
Carr W, Bernstein J, Lieberman P, Meltzer E, Bachert C, Price D, et al. A novel intranasal therapy of azelastine with fluticasone for the treatment of allergic rhinitis. J Allergy Clin Immunol. 2012;129:1282–9.CrossRefPubMed
39.
Meltzer E, Ratner P, Bachert C, Carr W, Berger W, Canonica GW, et al. Clinically relevant effect of a new intranasal therapy (MP29-02) in allergic rhinitis assessed by responder analysis. Int Arch Allergy Immunol. 2013;161:369–77.CrossRefPubMed
40.
Costa DJ, Amouyal M, Lambert P, Ryan D, Schunemann HJ, Daures JP, et al. How representative are clinical study patients with allergic rhinitis in primary care? J Allergy Clin Immunol. 2011;127:920–6.CrossRefPubMed
41.
Price D, Scadding G, Bachert C, Saleh H, Nasser S, Bichel K, et al. Dynamics of treatment within a year in patients diagnosed with either allergic, non-allergic rhinitis or hay fever over the period 1992–2012. Allergy. 2014;69:A284.
42.
Klimek L, Bachert C, Mosges R, Munzel U, Price D, Virchow JC, et al. Effectiveness of MP29-02 for the treatment of allergic rhinitis in real-life: results from a noninterventional study. Allergy Asthma Proc. 2015;36:40–7.CrossRefPubMed
43.
Scadding GK, Durham SR, Mirakian R, Jones NS, Leech SC, Farooque S, et al. BSACI guidelines for the management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2008;38:19–42.CrossRefPubMed
44.
45.
Acaster S, Ali S, Breheny K, Bachert C, Bousquet J, Price D. Treatment preferences in patients with moderate/severe seasonal allergic rhinitis: findings of a discrete choice experiment. Allergy. 2012;67:A891.
46.
Bousquet J, Schunemann HJ, Fonseca J, Samolinski B, Bachert C, Canonica GW et al. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): The new generation guideline implementation. Allergy. 2015 [Epub ahead of print].
Metadata
Title
The hidden burden of adult allergic rhinitis: UK healthcare resource utilisation survey
Authors
David Price
Glenis Scadding
Dermot Ryan
Claus Bachert
G. Walter Canonica
Joaquim Mullol
Ludger Klimek
Richard Pitman
Sarah Acaster
Ruth Murray
Jean Bousquet
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2015
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/s13601-015-0083-6

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