Advertisement

Treatments in Respiratory Medicine

, Volume 4, Issue 6, pp 439–446 | Cite as

Impact of Nasal Congestion on Quality of Life and Work Productivity in Allergic Rhinitis

Findings from a Large Online Survey
  • Arthur Shedden
Original Research Article

Abstract

Background: Allergic rhinitis is the most common allergic disease in the US. The predominant symptom of this condition is nasal congestion, which has a significant impact on quality of life and work productivity. This large survey was conducted to determine the impact of nasal congestion on the above parameters in individuals with allergic rhinitis, and treatment patterns for this symptom.

Methods: Participants were recruited voluntarily via telephone surveys and internet advertisements. Respondents with nasal congestion as a symptom of their allergic rhinitis (or who were primary caregivers to a child with nasal congestion associated with allergic rhinitis) were eligible for participation and completed a 52-question internet survey. Data were normalized to the US adult population using a weighting algorithm.

Results: Of the 2355 individuals with allergic rhinitis screened for participation in the survey, 2002 (85%) had nasal congestion. This was considered severe by 40% of respondents, compared with fewer than 30% who considered any other individual allergy symptom to be severe. Nasal congestion was the symptom that most adults and children wished to prevent, and it affected most respondents at work or school, had a notable emotional impact, and interfered with their ability to perform daily activities. Only 13% of participants receiving allergic rhinitis medication of any type, including over-the-counter medications, claimed to be very satisfied with treatment, and only 20% adhered completely to prescribing instructions. Although intranasal corticosteroids are recommended as first-line therapy for nasal congestion, only 30% of respondents with severe nasal congestion received treatment with intranasal corticosteroids.

Conclusions: Nasal congestion affects most individuals with allergic rhinitis, and has a notable impact on quality of life, emotional function, productivity, and the ability to perform daily activities. Patients need to be better educated on the appropriate use of medications, particularly intranasal corticosteroids, to manage their nasal congestion.

Keywords

Obstructive Sleep Apnea Allergic Rhinitis Montelukast Nasal Obstruction Nasal Congestion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

Arthur Shedden is an employee of Schering-Plough Corporation and was involved in the intellectual review of the manuscript.

The internet survey was conducted between May and June 2004 by an independent market research company (Roper Public Affairs Group part of NOP World, New York, New York, USA) on behalf of Schering-Plough Corporation, Kenilworth, New Jersey, USA. Roper Public Affairs prepared the survey questions after discussion with Schering-Plough Corporation.

Thomson Gardiner-Caldwell London, Maidenhead, UK, provided writing and editorial assistance which was funded by Schering-Plough Corporation.

References

  1. 1.
    Round Table Discussion. The health and economic impact of rhinitis. Am J Manag Care 1997; 3: S8–S18Google Scholar
  2. 2.
    The Allergy Report. Milwaukee (WI): American Academy of Allergy, Asthma and Immunology Inc., 2000. Available from URL: http://www.theallergyreport.org/reportindex.html [Accessed 2005 Oct 31]
  3. 3.
    Juniper EF, Guyatt GH. Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis. Clin Exp Allergy 1991; 21: 77–83PubMedCrossRefGoogle Scholar
  4. 4.
    Juniper EF, Guyatt GH, Dolovich J. Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: development and testing of a questionnaire for clinical trials. J Allergy Clin Immunol 1994; 93: 413–23PubMedCrossRefGoogle Scholar
  5. 5.
    Corey JP, Houser SM, Ng BA. Nasal congestion: a review of its etiology, evaluation, and treatment. Ear Nose Throat J 2000; 79: 690–3, 696, 698 passimPubMedGoogle Scholar
  6. 6.
    Jessen M, Malm L. Definition, prevalence and development of nasal obstruction. Allergy 1997; 52: 3–6PubMedCrossRefGoogle Scholar
  7. 7.
    Ciprandi G, Cirillo I, Vizzaccaro A, et al. Nasal obstruction in patients with seasonal allergic rhinitis: relationships between allergic inflammation and nasal airflow. Int Arch Allergy Immunol 2004; 134: 34–40PubMedCrossRefGoogle Scholar
  8. 8.
    Bachert C, van Kempen M, Van Cauwenberge P. Regulation of proinflammatory cytokines in seasonal allergic rhinitis. Int Arch Allergy Immunol 1999; 118: 375–9PubMedCrossRefGoogle Scholar
  9. 9.
    Ciprandi G, Cirillo I, Klersy C, et al. Nasal obstruction is the key symptom in hay fever patients. Otolaryngol Head Neck Surg 2005; 133: 429–35PubMedCrossRefGoogle Scholar
  10. 10.
    Naclerio R. Clinical manifestations of the release of histamine and other inflammatory mediators. J Allergy Clin Immunol 1999; 103 (3 Pt 2): S382–5PubMedCrossRefGoogle Scholar
  11. 11.
    Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleep-disordered breathing. The University of Wisconsin Sleep and Respiratory Research Group. J Allergy Clin Immunol 1997; 99: S757–62PubMedCrossRefGoogle Scholar
  12. 12.
    McColley SA, Carroll JL, Curtis S, et al. High prevalence of allergic sensitization in children with habitual snoring and obstructive sleep apnea. Chest 1997; 111: 170–3PubMedCrossRefGoogle Scholar
  13. 13.
    Kakumanu S, Glass C, Craig T. Poor sleep and daytime somnolence in allergic rhinitis: significance of nasal congestion. Am J Respir Med 2002; 1: 195–200PubMedCrossRefGoogle Scholar
  14. 14.
    Caprandi G, Cirillo I, Vizzaccaro A, et al. Airway function and nasal inflammation in seasonal allergic rhinitis and asthma. Clin Exp Allergy 2004; 34: 891–6CrossRefGoogle Scholar
  15. 15.
    Smolensky MH, Reinberg A, Labrecque G. Twenty-four hour pattern in symptom intensity of viral and allergic rhinitis: treatment implications. J Allergy Clin Immunol 1995; 95 (5 Pt 2): 1084–96PubMedCrossRefGoogle Scholar
  16. 16.
    Rappai M, Collop N, Kemp S, et al. The nose and sleep-disordered breathing: what we know and what we do not know. Chest 2003; 124: 2309–23PubMedCrossRefGoogle Scholar
  17. 17.
    Ferguson BJ. Influences of allergic rhinitis on sleep. Otolaryngol Head Neck Surg 2004; 130: 617–29PubMedCrossRefGoogle Scholar
  18. 18.
    Flemons WW, Tsai W. Quality of life consequences of sleep-disordered breathing. J Allergy Clin Immunol 1997; 99: S750–6PubMedCrossRefGoogle Scholar
  19. 19.
    McFadden EA, Gungor A, Ng B, et al. Loratadine/pseudoephedrine for nasal symptoms in seasonal allergic rhinitis: a double-blind, placebo-controlled study. Ear Nose Throat J 2000; 79: 254, 257-8, 260 passimPubMedGoogle Scholar
  20. 20.
    Nathan RA. Pharmacotherapy for allergic rhinitis: a critical review of leukotriene receptor antagonists compared with other treatments. Ann Allergy Asthma Immunol 2003; 90: 182–90PubMedCrossRefGoogle Scholar
  21. 21.
    Ratner PH, Paull BR, Findlay SR, et al. Fluticasone propionate given once daily is as effective for seasonal allergic rhinitis as beclomethasone dipropionate given twice daily. J Allergy Clin Immunol 1992; 90 (3 Pt 1): 285–91PubMedCrossRefGoogle Scholar
  22. 22.
    Bronsky EA, Dockhorn RJ, Meltzer EO, et al. Fluticasone propionate aqueous nasal spray compared with terfenadine tablets in the treatment of seasonal allergic rhinitis. J Allergy Clin Immunol 1996; 97: 915–21PubMedCrossRefGoogle Scholar
  23. 23.
    Welch MJ. Topical nasal steroids for allergic rhinitis. West J Med 1993; 158: 616–7PubMedGoogle Scholar
  24. 24.
    Graft D, Aaronson D, Chervinsky P, et al. A placebo- and active-controlled randomized trial of prophylactic treatment of seasonal allergic rhinitis with mometasone furoate aqueous nasal spray. J Allergy Clin Immunol 1996; 98: 724–31PubMedCrossRefGoogle Scholar
  25. 25.
    Hebert JR, Nolop K, Lutsky BN. Once-daily mometasone furoate aqueous nasal spray (Nasonex) in seasonal allergic rhinitis: an active- and placebo-controlled study. Allergy 1996; 51: 569–76PubMedGoogle Scholar
  26. 26.
    Mandl M, Nolop K, Lutsky BN. Comparison of once daily mometasone furoate (Nasonex) and fluticasone propionate aqueous nasal sprays for the treatment of perennial rhinitis. 194-079 Study Group. Ann Allergy Asthma Immunol 1997; 79: 370–8CrossRefGoogle Scholar
  27. 27.
    Craig TJ, Teets S, Lehman EB, et al. Nasal congestion secondary to allergic rhinitis as a cause of sleep disturbance and daytime fatigue and the response to topical nasal corticosteroids. J Allergy Clin Immunol 1998; 101: 633–7PubMedCrossRefGoogle Scholar
  28. 28.
    Storms WW. Minimal persistent inflammation, an emerging concept in the nature and treatment of allergic rhinitis: the possible role of leukotrienes. Ann Allergy Asthma Immunol 2003; 91: 131-40PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  • Arthur Shedden
    • 1
  1. 1.Schering-Plough CorporationKenilworthUSA

Personalised recommendations