Discrepancies in Guidelines for Allergy Management in Asia-Pacific.

Objectives: We have conducted this study to assess (1) the existence of prevention programmes for AR as developed by professional and health care organizations in Asia- Pacific countries; (2) any discrepancies in local guidelines in comparison to ARIA, or within and across these countries. Study design: Web search study. Methodology: We have conducted a study using Web search in accordance with the perspective of physicians or patients for the relevant prevention and pharmacotherapy guidelines in the management of AR as developed by professional and health care organizations in Asia-Pacific countries/regions. Results: National allergy (AR and/or asthma) preventive programs are found in only 6 out of 17 (22.2%) countries (excluding Japan and South Korea). There exist several aspects of discrepancies in existing educational programs such as in (1) allergic disease (asthma or AR) that the guidelines focus on; (2) targeted age groups (children or adults); and (3) breadth and depth of coverage, such as for particular inhalant allergens or food allergies only. Based on the information provided by MIMS website (updated in 2011 by UBM Medica, London, United Kingdom) and the MIMS proven by the country’s local health authority, controversies exist in recommended minimum age, doses and potential side-effects of many commonly used 2nd-generation antihistamines and intranasal corticosteroids. Conclusion: This is the first study that demonstrates discrepancies and a lack of public education programmes for AR prevention and management in Asia-Pacific countries/regions.

Allergic rhinitis and its impact on asthma update (ARIA 2008) - western and asian-pacific perspective.

The prevalence of allergic diseases such as allergic rhinitis (AR) and asthma is markedly increasing worldwide as societies adopt western life styles. Allergic sensitization is an important risk factor for asthma and AR, and asthma often co-exists with AR. An estimated 300 million people worldwide have asthma, about 50% of whom live in developing countries and about 400 million people suffer from AR. Yet, AR is often under-diagnosed and under-treated due to a lack of appreciation of the disease burden and its impact on quality of life, as well as its social impact at school and at the workplace. However, AR with or without asthma is a huge economic burden. Thus, there was clearly a need for a global evidence-based document which would highlight the interactions between the upper and lower airways including diagnosis, epidemiology, common risk factors, management and prevention. The Allergic Rhinitis and its Impact on Asthma (ARIA) document was first published in 2001 as a state-of-the-art guide-line for the specialist, the general practitioner and other health care professionals. Subsequent new evidence re-garding the pathomechanisms, new drugs and increased knowledge have resulted in the publication of the ARIA 2008 update. The present review summarizes the ARIA update with particular emphasis on the current status of AR and asthma in the Asia-Pacific region and discusses the Western and Asian perspective