| Publisher Information: |
Uppsala universitet, Allmänmedicin och preventivmedicin; Univ Sydney, Woolcock Inst Med Res, Qual Use Resp Med Grp, Sydney, NSW, Australia.;Royal Prince Alfred Hosp, Dept Resp & Sleep Med, Sydney, NSW, Australia.; Optimum Patient Care, Cambridge, England.;Observat & Pragmat Res Inst, Singapore, Singapore.;Univ Aberdeen, Ctr Acad Primary Care, Div Appl Hlth Sci, Aberdeen, Scotland.; Univ Ferrara, Resp Med, Ferrara, Italy.; Italian Interdisciplinary Soc Primary Care, Special Interest Resp Area, Bari, Italy.; Optimum Patient Care, Cambridge, England.;Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland.; Univ Florence, Dept Expt & Clin Med, Florence, Italy.; Inhalat Consultancy Ltd, Leeds, W Yorkshire, England.; NHS Greater Glasgow & Clyde R&D, Glasgow, Lanark, Scotland.; Box, Box Surg, Corsham, England.; Inst Invest Sanitaria Baleares IdISBa, Primary Care Resp Res Unit, Palma De Mallorca, Spain.; Norwegian Directorate Hlth, Dept Primary Hlth Care Serv, Oslo, Norway.; Univ Groningen, Univ Med Ctr Groningen, Dept Primary Care, Groningen, Netherlands.; Optimum Patient Care, Cambridge, England.;Observat & Pragmat Res Inst, Singapore, Singapore.; Univ Sydney, Woolcock Inst Med Res, Qual Use Resp Med Grp, Sydney, NSW, Australia.;Univ Sydney, Fac Med & Hlth, Sydney Med Sch, Sydney, NSW, Australia.;Cent Sydney Local Area Hlth Dist, Sydney, NSW, Australia.; DOVE MEDICAL PRESS LTD |
| Description: |
Purpose: There is a dearth of research regarding the prevalence and nature of patient-reported rhinitis and its relationship with risk of asthma exacerbations. The aim of this study was to (i) determine the prevalence, severity and treatment of self-reported rhinitis symptoms among adults aged >= 18 years with asthma treated at Global Initiative for Asthma (GINA) Step 3 and above and (ii) compare the demographics, clinical characteristics, medication use, side-effects and healthcare practitioner review between patients who report rhinitis symptoms and those who do not and (iii) determine whether patient-reported rhinitis is associated with risk of asthma exacerbations in the total patient sample. Patients and Methods: This analysis used data from the iHARP (Initiative Helping Asthma in Real-life Patients) asthma review service - a cross-sectional observational study (2011 and 2014) in seven countries that captured data on patient demographics, rhinitis symptoms, asthma symptoms, indicators of exacerbations, medication use, oropharyngeal effects and side-effects, using practitioner- and patient-reported questionnaires. Comparisons between patients with and without rhinitis were tested. Univariate logistic regression was used to identify variables associated with risk of exacerbations for entry into multivariable logistic regression. Results: This report contains data from 4274 patients: 67.4% (2881/4274) reported rhinitis symptoms and of which 65.7% (1894/2881) had not received a doctor diagnosis; 36.5% (1052/2881) had moderate-severe rhinitis, 12.4% (358/2881) had used intranasal corticosteroids and 19.8% (569/2881) oral antihistamines. Patients with coexisting moderate-severe rhinitis were more likely to have GINA-defined uncontrolled asthma than those with mild rhinitis or no rhinitis. Moderate-severe rhinitis was associated with 40% increased risk of asthma exacerbations (OR=1.40, 95% CI: 1.02-1.90). Conclusion: This study identified a major gap in the diagnosis and management of rhinitis in a cohort of ... |