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

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

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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.

Original languageEnglish
Article number39
JournalClinical and Translational Allergy
Volume5
Early online date18 Nov 2015
DOIs
Publication statusPublished - 20 Nov 2015

Keywords

  • allergic rhinitis
  • symptom episode
  • UK
  • co-medication
  • absenteeism
  • presenteeism

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    Price, D., Scadding, G., Ryan, D., Bachert, C., Canonica, G. W., Mullol, J., Klimek, L., Pitman, R., Acaster, S., Murray, R., & Bousquet, J. (2015). The hidden burden of adult allergic rhinitis: UK healthcare resource utilisation survey. Clinical and Translational Allergy, 5, [39]. https://doi.org/10.1186/s13601-015-0083-6