Abstract
Background Allergic rhinitis represents a public health problem that is significantly prevalent in the global population and has been associated with asthma, a strong desire to sleep and a low quality of life. Objective This study aims to evaluate the prevalence, symptoms, control strategies and treatment, as well as the control of this condition and its impact on the quality of life of customers of community pharmacies with allergic rhinitis. Setting A questionnaire survey was carried out in nine community pharmacies in the city of Guarda, Portugal. Method In this cross-sectional study, data was collected by an interview between May 2014 and December 2014. The control of the illness and the impact of allergic rhinitis on the quality of life were assessed through a CARAT10 test and a WHOQOL-BREF instrument, respectively. Main outcome measure The impact of allergic rhinitis on the patient’s quality of life. Results The estimated prevalence of allergic rhinitis was between 10.8% and 15.4%, from which 63 and 42 individuals were medically and symptomatically diagnosed, respectively, from a study population of 804 respondents. The majority of participants (57.1%) suffered from the symptoms more than twice a year. The symptoms, such as difficulty in falling asleep, repeated and continuous sneezing and bilateral nasal obstruction, were severe. There were patients with uncontrolled allergic rhinitis symptoms after the CARAT10 test, even when the individual’s perception of the quality of life was good according to the WHOQOL-BREF score, with gender differences in the psychological domain. It should also be emphasized that there was a significant association between higher education levels with better control of the illness/quality of life. Additionally, most participants used pharmacological treatment (not alternative therapies) and the adoption of self-management measures to relieve their symptoms. Conclusions The findings of this study showed that the estimated prevalence of allergic rhinitis seems to be apparently lower in Guarda than that found in the general Portuguese population. From the data, some patients showed uncontrolled allergic rhinitis symptoms, strengthening the importance of the role of intervention by a health professional.
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References
Morais-Almeida M, Loureiro C, Todo-Bom A, Nunes C, Pereira C, Delgado L, et al. Avaliação da prevalência e caracterização da rinite em utentes dos cuidados de saúde primários de Portugal Continental-Estudo ARPA. Rev Port Imunoalergologia. 2005;13:69–80.
Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004;24:758–64.
Arsoy G, Varis A, Saloumi LM, Abdi A, Basgut B. Insights on allergic rhinitis management from a Northern Cyprus perspective and evaluation of the impact of pharmacist-led educational intervention on patients’ outcomes. Medicina (Kaunas). 2018;54:83. https://doi.org/10.3390/medicina54050083.
Mandhane SN, Shah JH, Thennati R. Allergic rhinitis: an update on disease, present treatments and future prospects. Int Immunopharmacol. 2011;11:1646–62.
Bousquet J, Arnavielhe S, Bedbrook A, Bewick M, Laune D, Mathieu-Dupas E, et al. MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence. Clin Transl Allergy. 2018;8:45. https://doi.org/10.1186/s13601-018-0227-6.
Fonseca JA, Nogueira-Silva L, Morais-Almeida M, Azevedo L, Sa-Sousa A, Branco-Ferreira M, et al. Validation of a questionnaire (CARAT10) to assess rhinitis and asthma in patients with asthma. Allergy. 2010;65:1042–8.
Fonseca JA, Nogueira-Silva L, Morais-Almeida M, Sa-Sousa A, Azevedo LF, Ferreira J, et al. Control of Allergic Rhinitis and Asthma Test (CARAT) can be used to assess individual patients over time. Clin Transl Allergy. 2012;2:16. https://doi.org/10.1186/2045-7022-2-16.
CARAT – Control of Allergic Rhinitis and Asthma Test. 2020. http://www.caratnetwork.org/fastcarat/index.html. Accessed 15 May 2020.
Kremer B. Quality of life scales in allergic rhinitis. Curr Opin Allergy Clin Immunol. 2004;4:171–6.
Canavarro MC, Vaz Serra A, Pereira M, Simões MR, Quartilho MJ, Rijo D, et al. WHOQOL disponível para Portugal: desenvolvimento dos instrumentos de avaliação da qualidade de vida da Organização Mundial de Saúde (WHOQOL-100 e WHOQOL-BREF). In: Canavarro MC, Vaz Serra A, editors. Qualidade de vida e saúde: Uma abordagem na perspectiva da Organização Mundial de Saúde Lisboa: Fundação Calouste Gulbenkian; 2010. pp. 171–190.
Ozdoganoglu T, Songu M, Inancli HM. Quality of life in allergic rhinitis. Ther Adv Respir Dis. 2012;6:25–39.
Fineman SM. The burden of allergic rhinitis: beyond dollars and cents. Ann Allergy Asthma Immunol. 2002;88:2–7.
Ozdoganoglu T, Songu M. The burden of allergic rhinitis and asthma. Ther Adv Respir Dis. 2012;6:11–23.
O’Connor J, Seeto C, Saini B, Bosnic-Anticevich S, Krass I, Armour C, et al. Healthcare professional versus patient goal setting in intermittent allergic rhinitis. Patient Educ Couns. 2008;70:111–7.
May JR, Dolen WK. Management of allergic rhinitis: a review for the community pharmacist. Clin Ther. 2017;39:2410–9.
Yap JSY, Tang CWQ, Hor HML, Chong JBK, Yap KZ. Process evaluation of the Community Pharmacist-led Allergic Rhinitis Management (C-PhARM) service in Singapore. Pharmacy (Basel). 2019;7:56. https://doi.org/10.3390/pharmacy7020056.
Tan R, Cvetkovski B, Kritikos V, Yan K, Price D, Smith P, et al. Management of allergic rhinitis in the community pharmacy: identifying the reasons behind medication self-selection. Pharm Pract (Granada). 2018. https://doi.org/10.18549/PharmPract.2018.03.1332.
Lourenco O, Calado S, Sa-Sousa A, Fonseca J. Evaluation of allergic rhinitis and asthma control in a Portuguese community pharmacy setting. J Manag Care Pharm. 2014;20:513–22.
Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011;2:53–5.
Thompson A, Sardana N, Craig TJ. Sleep impairment and daytime sleepiness in patients with allergic rhinitis: the role of congestion and inflammation. Ann Allergy Asthma Immunol. 2013;111:446–51.
Gani F, Lombardi C, Barrocu L, Landi M, Ridolo E, Bugiani M, et al. The control of allergic rhinitis in real life: a multicenter cross-sectional Italian study. Clin Mol Allergy. 2018;16:4. https://doi.org/10.1186/s12948-018-0082-y.
Smith L, Nguyen T, Seeto C, Saini B, Brown L. The role of non-clinicians in a goal setting model for the management of allergic rhinitis in community pharmacy settings. Patient Educ Couns. 2011;85:e26–32.
Wang Y, Chen H, Zhu R, Liu G, Huang N, Li W, et al. Allergic Rhinitis Control Test questionnaire-driven stepwise strategy to improve allergic rhinitis control: a prospective study. Allergy. 2016;71:1612–9.
Wang Y, Zhu R, Liu G, Li W, Chen H, Daures JP, et al. Prevalence of uncontrolled allergic rhinitis in Wuhan, China: a prospective cohort study. Am J Rhinol Allergy. 2014;28:397–403.
Bosnic-Anticevich S, Costa E, Menditto E, Lourenco O, Novellino E, Bialek S, et al. ARIA pharmacy 2018 “Allergic rhinitis care pathways for community pharmacy”. Allergy. 2019;74:1219–36.
Bousquet J, Bedbrook A, Czarlewski W, Onorato GL, Arnavielhe S, Laune D, et al. Guidance to 2018 good practice: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma. Clin Transl Allergy. 2019;9:16.
Castillo Vizuete JA, Sastre J, Del Cuvillo BA, Picado C, Martinez Moragon E, Ignacio Garcia JM, et al. Asthma, rhinitis, and nasal polyp multimorbidities. Arch Bronconeumol. 2019;55:146–55.
Kalpaklioǧlu AF, Baççioǧlu A. Evaluation of quality of life: impact of allergic rhinitis on asthma. J Investig Allergol Clin Immunol. 2008;18:168–73.
Maspero J, Lee BW, Katelaris CH, Potter PC, Cingi C, Lopatin A, et al. Quality of life and control of allergic rhinitis in patients from regions beyond western Europe and the United States. Clin Exp Allergy. 2012;42:1684–96.
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This research received no specific grant from any funding agency in the public, commercial or non-profit sectors. The authors would like to thank all those who participated in this study and Professor Samuel Walter Best from the Polytechnic Institute of Guarda for proofreading assistance. The authors also acknowledge all the editor and referees’ comments and recommendations.
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Guedes, H., Morgado, M., Rodrigues, M. et al. Allergic rhinitis characterization in community pharmacy customers: a cross-sectional study. Int J Clin Pharm 43, 118–127 (2021). https://doi.org/10.1007/s11096-020-01115-z
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DOI: https://doi.org/10.1007/s11096-020-01115-z