Real-life treatment of rhinitis in Australia

a historical cohort study of prescription and over-the-counter therapies for patients with and without additional respiratory disease

David B Price, Pete K Smith, Richard John Harvey, A Simon Carney, Vicky Kritikos, Sinthia Z Bosnic-Anticevich, Louise Christian, Derek Skinner, Victoria Carter, Alice Ms Durieux

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Abstract

Background: The aim of the study was to explore rhinitis therapy purchases in different Australian regions for patients with and without additional respiratory disease, using both doctor's prescriptions and over-the-counter (OTC) medications.

Patients and methods: It was a historical cohort study of pharmacy-related claims that included prescription or OTC rhinitis therapy, with or without asthma/COPD therapy, from January 2013 to December 2014.

Results: Overall, 4,247,193 prescription and OTC rhinitis treatments were purchased from 909 pharmacies over a calendar year; the majority were single-therapy purchases for rhinitis only patients. More multiple-therapy was purchased for rhinitis and asthma/COPD patients (4.4%) than for rhinitis only patients (4.0%), with a greater proportion purchased in VIC, SA and TAS (4.7% of rhinitis only patients and 4.5% of rhinitis and asthma/COPD patients) than in other areas. Dual therapy of oral antihistamine (OAH) and intranasal corticosteroid (INS) were the most frequently purchased multiple-therapy, with higher purchasing rates for rhinitis and asthma/COPD patients (2.6%) than for rhinitis only patients (1.6%). The most frequently purchased single therapy was OAH (70.1% of rhinitis only patients and 57.3% of rhinitis and asthma/COPD patients). First-line INS therapy was more likely to be purchased for rhinitis and asthma/COPD patients (15.3% by prescription and 11.7% OTC) than for rhinitis only patients (5.0% by prescription and 9.2% OTC); however, geographical differences in the proportion of therapies purchased OTC were noted, with a lower proportion of OTC OAH and INS purchases in Queensland and the Northern Territory for patients with and without comorbid respiratory disease.

Conclusion: Purchases of first-line INS therapy are more likely for patients with comorbid respiratory disease if they have received prescriptions and information/advice from their general practitioner. The study results indicate a need for patient information/education at the point-of-sale of OTC OAHs to enable patients to assess their nasal symptoms and receive treatment support from pharmacists. Greater availability to INSs in pharmacies as well as guidance from current guidelines and instruction in correct intranasal technique may also lead to greater uptake of INSs.

Original languageEnglish
Pages (from-to)43-54
Number of pages12
JournalPragmatic and Observational Research
Volume9
DOIs
Publication statusPublished - 15 Aug 2018

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Rhinitis
Prescriptions
Cohort Studies
Chronic Obstructive Pulmonary Disease
Asthma
Therapeutics
Histamine Antagonists
Adrenal Cortex Hormones
Pharmacies
Northern Territory
Queensland
Patient Education
Nose
Pharmacists
General Practitioners

Keywords

  • asthma
  • chronic obstructive airways disease
  • intranasal corticosteroids
  • medication
  • oral antihistamines
  • over-the-counter
  • pharmacy

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Real-life treatment of rhinitis in Australia : a historical cohort study of prescription and over-the-counter therapies for patients with and without additional respiratory disease. / Price, David B; Smith, Pete K; Harvey, Richard John; Carney, A Simon; Kritikos, Vicky; Bosnic-Anticevich, Sinthia Z; Christian, Louise; Skinner, Derek; Carter, Victoria; Durieux, Alice Ms.

In: Pragmatic and Observational Research, Vol. 9, 15.08.2018, p. 43-54.

Research output: Contribution to journalArticle

Price, David B ; Smith, Pete K ; Harvey, Richard John ; Carney, A Simon ; Kritikos, Vicky ; Bosnic-Anticevich, Sinthia Z ; Christian, Louise ; Skinner, Derek ; Carter, Victoria ; Durieux, Alice Ms. / Real-life treatment of rhinitis in Australia : a historical cohort study of prescription and over-the-counter therapies for patients with and without additional respiratory disease. In: Pragmatic and Observational Research. 2018 ; Vol. 9. pp. 43-54.
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abstract = "Background: The aim of the study was to explore rhinitis therapy purchases in different Australian regions for patients with and without additional respiratory disease, using both doctor's prescriptions and over-the-counter (OTC) medications.Patients and methods: It was a historical cohort study of pharmacy-related claims that included prescription or OTC rhinitis therapy, with or without asthma/COPD therapy, from January 2013 to December 2014.Results: Overall, 4,247,193 prescription and OTC rhinitis treatments were purchased from 909 pharmacies over a calendar year; the majority were single-therapy purchases for rhinitis only patients. More multiple-therapy was purchased for rhinitis and asthma/COPD patients (4.4{\%}) than for rhinitis only patients (4.0{\%}), with a greater proportion purchased in VIC, SA and TAS (4.7{\%} of rhinitis only patients and 4.5{\%} of rhinitis and asthma/COPD patients) than in other areas. Dual therapy of oral antihistamine (OAH) and intranasal corticosteroid (INS) were the most frequently purchased multiple-therapy, with higher purchasing rates for rhinitis and asthma/COPD patients (2.6{\%}) than for rhinitis only patients (1.6{\%}). The most frequently purchased single therapy was OAH (70.1{\%} of rhinitis only patients and 57.3{\%} of rhinitis and asthma/COPD patients). First-line INS therapy was more likely to be purchased for rhinitis and asthma/COPD patients (15.3{\%} by prescription and 11.7{\%} OTC) than for rhinitis only patients (5.0{\%} by prescription and 9.2{\%} OTC); however, geographical differences in the proportion of therapies purchased OTC were noted, with a lower proportion of OTC OAH and INS purchases in Queensland and the Northern Territory for patients with and without comorbid respiratory disease.Conclusion: Purchases of first-line INS therapy are more likely for patients with comorbid respiratory disease if they have received prescriptions and information/advice from their general practitioner. The study results indicate a need for patient information/education at the point-of-sale of OTC OAHs to enable patients to assess their nasal symptoms and receive treatment support from pharmacists. Greater availability to INSs in pharmacies as well as guidance from current guidelines and instruction in correct intranasal technique may also lead to greater uptake of INSs.",
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T2 - a historical cohort study of prescription and over-the-counter therapies for patients with and without additional respiratory disease

AU - Price, David B

AU - Smith, Pete K

AU - Harvey, Richard John

AU - Carney, A Simon

AU - Kritikos, Vicky

AU - Bosnic-Anticevich, Sinthia Z

AU - Christian, Louise

AU - Skinner, Derek

AU - Carter, Victoria

AU - Durieux, Alice Ms

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N2 - Background: The aim of the study was to explore rhinitis therapy purchases in different Australian regions for patients with and without additional respiratory disease, using both doctor's prescriptions and over-the-counter (OTC) medications.Patients and methods: It was a historical cohort study of pharmacy-related claims that included prescription or OTC rhinitis therapy, with or without asthma/COPD therapy, from January 2013 to December 2014.Results: Overall, 4,247,193 prescription and OTC rhinitis treatments were purchased from 909 pharmacies over a calendar year; the majority were single-therapy purchases for rhinitis only patients. More multiple-therapy was purchased for rhinitis and asthma/COPD patients (4.4%) than for rhinitis only patients (4.0%), with a greater proportion purchased in VIC, SA and TAS (4.7% of rhinitis only patients and 4.5% of rhinitis and asthma/COPD patients) than in other areas. Dual therapy of oral antihistamine (OAH) and intranasal corticosteroid (INS) were the most frequently purchased multiple-therapy, with higher purchasing rates for rhinitis and asthma/COPD patients (2.6%) than for rhinitis only patients (1.6%). The most frequently purchased single therapy was OAH (70.1% of rhinitis only patients and 57.3% of rhinitis and asthma/COPD patients). First-line INS therapy was more likely to be purchased for rhinitis and asthma/COPD patients (15.3% by prescription and 11.7% OTC) than for rhinitis only patients (5.0% by prescription and 9.2% OTC); however, geographical differences in the proportion of therapies purchased OTC were noted, with a lower proportion of OTC OAH and INS purchases in Queensland and the Northern Territory for patients with and without comorbid respiratory disease.Conclusion: Purchases of first-line INS therapy are more likely for patients with comorbid respiratory disease if they have received prescriptions and information/advice from their general practitioner. The study results indicate a need for patient information/education at the point-of-sale of OTC OAHs to enable patients to assess their nasal symptoms and receive treatment support from pharmacists. Greater availability to INSs in pharmacies as well as guidance from current guidelines and instruction in correct intranasal technique may also lead to greater uptake of INSs.

AB - Background: The aim of the study was to explore rhinitis therapy purchases in different Australian regions for patients with and without additional respiratory disease, using both doctor's prescriptions and over-the-counter (OTC) medications.Patients and methods: It was a historical cohort study of pharmacy-related claims that included prescription or OTC rhinitis therapy, with or without asthma/COPD therapy, from January 2013 to December 2014.Results: Overall, 4,247,193 prescription and OTC rhinitis treatments were purchased from 909 pharmacies over a calendar year; the majority were single-therapy purchases for rhinitis only patients. More multiple-therapy was purchased for rhinitis and asthma/COPD patients (4.4%) than for rhinitis only patients (4.0%), with a greater proportion purchased in VIC, SA and TAS (4.7% of rhinitis only patients and 4.5% of rhinitis and asthma/COPD patients) than in other areas. Dual therapy of oral antihistamine (OAH) and intranasal corticosteroid (INS) were the most frequently purchased multiple-therapy, with higher purchasing rates for rhinitis and asthma/COPD patients (2.6%) than for rhinitis only patients (1.6%). The most frequently purchased single therapy was OAH (70.1% of rhinitis only patients and 57.3% of rhinitis and asthma/COPD patients). First-line INS therapy was more likely to be purchased for rhinitis and asthma/COPD patients (15.3% by prescription and 11.7% OTC) than for rhinitis only patients (5.0% by prescription and 9.2% OTC); however, geographical differences in the proportion of therapies purchased OTC were noted, with a lower proportion of OTC OAH and INS purchases in Queensland and the Northern Territory for patients with and without comorbid respiratory disease.Conclusion: Purchases of first-line INS therapy are more likely for patients with comorbid respiratory disease if they have received prescriptions and information/advice from their general practitioner. The study results indicate a need for patient information/education at the point-of-sale of OTC OAHs to enable patients to assess their nasal symptoms and receive treatment support from pharmacists. Greater availability to INSs in pharmacies as well as guidance from current guidelines and instruction in correct intranasal technique may also lead to greater uptake of INSs.

KW - asthma

KW - chronic obstructive airways disease

KW - intranasal corticosteroids

KW - medication

KW - oral antihistamines

KW - over-the-counter

KW - pharmacy

U2 - 10.2147/POR.S153266

DO - 10.2147/POR.S153266

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VL - 9

SP - 43

EP - 54

JO - Pragmatic and Observational Research

JF - Pragmatic and Observational Research

SN - 1179-7266

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