UK prescribing practices as proxy markers of unmet need in allergic rhinitis: a retrospective observational study

David B. Price, Glenis Scadding, Claus Bachert, Hesham Saleh, Shuaib Nasser, Victoria Carter, Julie von Ziegenweidt, Alice M. S. Durieux, Dermot Ryan

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Abstract

Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67% of patients with seasonal AR (SAR) and 77% of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for >20% of SAR and >37% of NSUAD patients. Multiple therapy was the initial prescription for 33% of SAR and 23% of NSUAD in both years, rising to 45% and >50% by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies.

Original languageEnglish
Article number16033
Pages (from-to)1-8
Number of pages8
Journalnpj Primary Care Respiratory Medicine
Volume26
Early online date23 Jun 2016
DOIs
Publication statusPublished - 2016

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Proxy
Observational Studies
Retrospective Studies
Prescriptions
General Practitioners
Histamine Antagonists
Rhinitis
Therapeutics
Adrenal Cortex Hormones
Allergic Rhinitis
Seasonal Allergic Rhinitis
Pollen
Patient Care
Databases
Research

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UK prescribing practices as proxy markers of unmet need in allergic rhinitis : a retrospective observational study. / Price, David B.; Scadding, Glenis; Bachert, Claus; Saleh, Hesham; Nasser, Shuaib; Carter, Victoria; von Ziegenweidt, Julie; Durieux, Alice M. S.; Ryan, Dermot.

In: npj Primary Care Respiratory Medicine, Vol. 26, 16033, 2016, p. 1-8.

Research output: Contribution to journalArticle

Price, DB, Scadding, G, Bachert, C, Saleh, H, Nasser, S, Carter, V, von Ziegenweidt, J, Durieux, AMS & Ryan, D 2016, 'UK prescribing practices as proxy markers of unmet need in allergic rhinitis: a retrospective observational study', npj Primary Care Respiratory Medicine, vol. 26, 16033, pp. 1-8. https://doi.org/10.1038/npjpcrm.2016.33
Price, David B. ; Scadding, Glenis ; Bachert, Claus ; Saleh, Hesham ; Nasser, Shuaib ; Carter, Victoria ; von Ziegenweidt, Julie ; Durieux, Alice M. S. ; Ryan, Dermot. / UK prescribing practices as proxy markers of unmet need in allergic rhinitis : a retrospective observational study. In: npj Primary Care Respiratory Medicine. 2016 ; Vol. 26. pp. 1-8.
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abstract = "Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67{\%} of patients with seasonal AR (SAR) and 77{\%} of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for >20{\%} of SAR and >37{\%} of NSUAD patients. Multiple therapy was the initial prescription for 33{\%} of SAR and 23{\%} of NSUAD in both years, rising to 45{\%} and >50{\%} by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies.",
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AU - Nasser, Shuaib

AU - Carter, Victoria

AU - von Ziegenweidt, Julie

AU - Durieux, Alice M. S.

AU - Ryan, Dermot

N1 - Acknowledgements We thank Ruth B Murray for reviewing and editing this manuscript. We thank Joan B Soriano for his critical review and constructive comments. We thank Helga Mikkelsen and Alessandra Cifra for their assistance with manuscript editing and revision. Finally, we thank the Journal blind peer reviewers, whose suggestions and critical appraisal significantly improved our original submission. FUNDING This study was funded by Meda, Solna, Sweden. Data acquisition and analyses were funded by Meda. The study was conducted by Research in Real Life as an independent research organisation; Meda had no role in the conduct or reporting of the study.

PY - 2016

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N2 - Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67% of patients with seasonal AR (SAR) and 77% of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for >20% of SAR and >37% of NSUAD patients. Multiple therapy was the initial prescription for 33% of SAR and 23% of NSUAD in both years, rising to 45% and >50% by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies.

AB - Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67% of patients with seasonal AR (SAR) and 77% of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for >20% of SAR and >37% of NSUAD patients. Multiple therapy was the initial prescription for 33% of SAR and 23% of NSUAD in both years, rising to 45% and >50% by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies.

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