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.
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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.
Round Table Discussion. The health and economic impact of rhinitis. Am J Manag Care 1997; 3: S8–S18Google Scholar
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
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
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
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
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
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
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
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
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
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
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
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
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
Flemons WW, Tsai W. Quality of life consequences of sleep-disordered breathing. J Allergy Clin Immunol 1997; 99: S750–6PubMedCrossRefGoogle Scholar
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
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
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
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
Welch MJ. Topical nasal steroids for allergic rhinitis. West J Med 1993; 158: 616–7PubMedGoogle Scholar
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
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
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
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
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