Relative strength of relationships of nasal congestion and ocular symptoms with sleep, mood and productivity

ABSTRACT

Background: Nasal congestion associated with allergic rhinitis has been shown to be the most bothersome symptom. Ocular symptoms may be troublesome to patients as well.

Objective: To estimate the relative strength of relationships of nasal congestion and ocular symptoms associated with allergic rhinitis with patient-reported outcomes of sleep quality; practical problems; somnolence; impairment at work, class, activities; and mood.

Methods: Patients (n = 404) presenting with symptoms of allergic rhinitis completed five patient-reported outcomes that assessed the effect of morning allergic rhinitis symptoms on patients’ reports of sleep, work and activity impairment, and mood. Multiple regression analyses were used to compare the relative strength of relationships of congestion and ocular symptoms with the patient-reported outcomes.

Results: The majority of patients had both nasal congestion and ocular symptoms at baseline. A single nasal congestion item and a 3-item ocular symptom score were significantly related to the patient-reported outcomes: those with more severe congestion or ocular symptoms reported more negative scores on the patient-reported outcomes. Nasal congestion had the stronger relationship with patient-reported outcomes total scores or subscales in 14 of 20 regressions.

Conclusion: Although nasal congestion is generally more strongly related to the patient-reported outcomes, ocular symptoms have a significant negative effect on patients’ lives. Study limitations include: (1) only baseline data were used because of greater severity and variability of symptoms scores; we are unable to establish causal relationships or discuss change, only correlation/covariation; (2) recruitment took place from September through November, thus different patients might have been recruited if sampling took place during the spring; (3) patients were screened for nasal congestion not for ocular symptoms, though there was high co-occurrence of each. These limitations aside, congestion and ocular symptoms are troublesome to patients and typically co-occur. Evaluating and treating these symptoms are key to managing allergic rhinitis and improving patient-reported outcomes.

Keywords: :

• Allergic rhinitis
• Nasal congestion
• Ocular symptoms
• Patient-reported outcomes

Transparency

Declaration of funding

This research was sponsored by Schering-Plough Corporation. The scope of the study and interpretation of results involved all co-authors equally. The analyses were conducted by D.E.S. and M.S. The original study that collected the data used in these analyses was led by D.E.S. All co-authors reviewed and edited the manuscript prior to submission.

Declaration of financial/other relationships

S.C. is an employee of Schering-Plough Corporation. D.W.S. has disclosed that at the time of study conception, he was an employee of Schering-Plough, and that he received no compensation for his participation in this research and has no relevant financial interests. D.E.S. and M.S. are employees of United BioSource Corporation, which provides consulting and other research services to pharmaceutical, device, government, and non-government organizations. In this salaried position, they work with a variety of companies and organizations and have received no payment or honoraria directly from the sponsors.

All peer reviewers receive honoraria from CMRO for their review work. Peer Reviewer 1 has disclosed that he/she serves as a consultant, advisor and speaker for several pharmaceutical companies, including Schering-Plough; and that he/she has received research grants and honoraria from several pharmaceutical companies, including Schering-Plough. Peer Reviewer 2 has disclosed that he/she has no relevant financial relationships.

Acknowledgments

No non-author assistance was provided during the preparation of this article. The authors thank the two anonymous reviewers for their excellent and detailed suggestions and comments that strengthened this article.