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ABSTRACT
Objective: To determine the characteristics of asthma (A) and allergic rhinitis (AR) among asthma patients in primary care practice.
Research design and methods: Primary care physicians, pulmonologists, and allergologists were asked to recruit consecutive asthma patients with or without allergic rhinitis from their daily practice. Cross-sectional data on symptoms, severity, treatment and impact on quality of life of A and AR were recorded and examined using descriptive statistics. Patients with and without AR were then compared.
Results: 1244 asthma patients were included by 211 physicians. Asthma was controlled in 19%, partially controlled in 27% and not controlled in 54%. Asthma treatment was generally based on inhaled corticosteroids (ICS) with or without long acting beta 2 agonists (78%). A leukotriene receptor antagonist (LTRA) was used by 46% of the patients. Overall, 950 (76%) asthma patients had AR (A + AR) and 294 (24%) did not (A − AR). Compared to patients with A − AR, A + AR patients were generally younger (mean age ± standard deviation: 42 ± 16 vs. 50 ± 19 years, p < 0.001) and fewer used ICS (75% vs. 88%, p < 0.001). LTRA usage was similar in both groups (46% vs. 48%). Asthma was uncontrolled in 53% of A + AR and 57% of A − AR patients. Allergic rhinitis was treated with a mean of 1.9 specific AR medications: antihistamines (77%), nasal steroids (66%) and/or vasoconstrictors (38%), and/or LTRA (42%). Rhinorrhoea, nasal obstruction, or nasal itching were the most frequently reported AR symptoms and the greatest reported degree of impairment was in daily activities/sports (55%).
Conclusions: Allergic rhinitis was more common among younger asthma patients, increased the burden of symptoms and the need for additional medication but was associated with improved asthma control. However, most asthma patients remained suboptimally controlled regardl-ess of concomitant AR.
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Acknowledgements
Declaration of interest: The survey was funded by Merck Sharp and Dohme-Chibret AG, Switzerland, manufacturers of the LTRA montelukast. We are grateful to Dr Philippe Kress, Kressmed Glattbrugg Switzerland, for his contribution to data analysis and the writing of the manuscript. All authors listed have contributed to its editing and approved the final version for publication; none of the authors report other potential conflicts of interest in relation to this study.