Knowledge and Attitude Among Patients and Physicians on Allergic Rhinitis (KAPPA): An International Survey

Abstract

Purpose

Our study compared knowledge of, and attitudes towards, allergic rhinitis (AR) among patients and physicians in: Brazil, Japan, Korea, Mexico, Saudi Arabia, Spain, United Arab Emirates, and the United Kingdom.

Patients and Methods

Patients with AR were recruited via probability-based sampling. Data were captured via telephone interview, personal interview, or self-administered online survey. Physicians were recruited from an online physician panel and interviewed by self-administered online survey.

Results

In total, 1436 patients and 1637 physicians were surveyed. Most patients (76.9%) reported moderate-to-severe AR, whereas physicians reported more mild (mean cases ranging from 57.0–68.2) than moderate-to-severe AR (mean cases ranging from 31.8–43.0). Overall, most physicians (85.4%) and patients (77.5%) agreed AR could be controlled with treatment. Physicians preferred prescribing oral antihistamines (OAHs) for mild AR (from 45.3% of physicians in Brazil to 73.6% of physicians in Mexico). For moderate and severe AR, more physicians preferred prescribing intranasal corticosteroids (INCSs) and OAHs for moderate and severe AR than other available treatments (from 48.5% of physicians in the UK to 69.5% of physicians in Spain). Patients preferred OAHs to INCSs for treating AR (62.0%). Patients also reported a range of comorbidities: overall, sinus infections were the most common (24.7%), and comorbid asthma was present in 12.9% of patients. Per country, Saudi Arabia had the highest proportion (53.5%) and Mexico had the lowest proportion (8.0%) of patients with comorbid asthma.

Conclusion

Patient and physician perceptions of AR mostly differed between and within countries, although there was generally agreement that AR could be controlled with treatment. Differing attitudes towards AR among patients and physicians suggests a need for improved education in and communication between these groups, with subsequent implications for optimizing disease management.

Keywords:

• allergy
• allergic rhinitis
• intranasal corticosteroids
• oral antihistamines
• treatment preference

Abbreviations

ANOVA, Analysis of variance; AP, Area probability; AR, Allergic rhinitis; ENT, Ear, nose, and throat; ER, Emergency room; EU, European Union; F2F, Face-to-face; GP, General practitioner; INCS, Intranasal corticosteroid; KAPPA, Knowledge and Attitude among Patients and Physicians on Allergic rhinitis; NE, Not evaluated; OAH, Oral antihistamine; OTC, Over the counter; RDD, Random digit dialing; SA, Saudi Arabia; SD, Standard deviation; UAE, United Arab Emirates; UK, United Kingdom; WP, Web panel.

Data Sharing Statement

Information on GSK’s data sharing commitments and requesting access to anonymized individual participant data and associated documents can be found at www.clinicalstudydatarequest.com.

Ethics Approval and Informed Consent

The study sponsor was not revealed until study end in non-EU countries; collection of data in EU countries complied with General Data Protection Regulation guidelines and so the study sponsor was revealed as part of the informed consent form. Adults provided their consent to participate, and parents or caregivers completed the survey on behalf of their children. All survey responses were protected by confidentiality and no identifying information could be linked to the survey data.

Consent for Publication

All authors critically reviewed the manuscript for important intellectual content at each draft and approved the final version for submission.

Acknowledgments

The authors would like to thank Sheila Chua (formerly of GSK) and Anup Pingle (GSK) for their contributions to study design and data acquisition, interpretation, and analysis; Priya Jain (GSK) for her contributions to data acquisition, interpretation, and analysis; and Jeanne Pimenta (formerly of GSK) for her contributions to developing the KAPPA study protocol. Trademarks are the property of their respective owners.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

C. Bhargave, M. Verma, and R. W. Jakes are employees of, and shareholders in, GSK. Y. Okamoto has received speaker fees from Torii Co. Ltd., Novartis, Tanabe Mitsubishi Co. Ltd., Kirin Co. Ltd., ALK Co. Ltd., Shionogi Co. Ltd., and Meiji Pharma Co. Ltd. The authors report no other conflicts of interest in this work.

Additional information

Funding

GSK provided financial support for the conduct of the research (study number 210004) and preparation of the article; the study sponsor had no involvement in: study design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the article for publication. Medical writing support (in the form of manuscript development, collating author comments, assembling tables/figures, grammatical editing, and referencing) was provided by Joanna Wilson, PhD, of Ashfield MedComms (Glasgow, UK), an Inizio company, and was funded by GSK.