Current Allergic Rhinitis Experiences Survey (CARES): Consumers' awareness, attitudes and practices.

Allergic rhinitis (AR) affects ~60 million people in the United States. This study evaluates awareness, attitudes, and behaviors of AR sufferers on the management of their condition. This U.S.-based survey evaluated 1600 adult AR sufferers to assess their perceptions of AR diagnosis, treatment preferences, and interactions with health care practitioners (HCPs). Two consumer groups of AR sufferers were assessed: users of over-the-counter (OTC) medications only (n = 1020) and users of prescription (Rx) ± OTC medications (n = 580). The Rx group included 451 intranasal steroid (INS) users. Eighty-two percent of respondents indicated that they require minimal to no HCP guidance to manage AR; 51% had not visited an HCP in the past 2 years. Eighty-six percent of respondents agreed that they can self-recognize AR symptoms, and 69% suspected allergies before diagnosis. On suspecting nasal allergies, 52% of sufferers purchased an OTC medication. Seventy-two percent of AR sufferers said they are likely to go to an HCP if symptoms persist after they tried multiple OTC options. Rx users perceived INSs to be more beneficial in treating AR and showed a high level of satisfaction (a score of 7.4 out of 10). Forty-eight percent of AR sufferers felt the need for more efficacious OTC medications to better manage their AR symptoms. This study indicated that AR sufferers perceive that they self-recognize AR symptoms and initiate their management with OTC options. The availability of OTC medications did not deter AR sufferers from visiting HCPs for advice when symptoms worsen. Nonetheless, more efficacious OTC options are still desired.

Current Allergic Rhinitis Experiences Survey (CARES): Health-care practitioners' awareness, attitudes and practices.

Allergic rhinitis (AR) is a common health problem in the United States, with significant comorbidities and impairment of quality of life despite the availability of many prescription (Rx) and over-the-counter (OTC) medications. The health-care practitioners (HCPs) arm of the Current Allergic Rhinitis Experiences Survey (CARES) assessed HCPs' perceptions about the current management of AR. This U.S.-based national survey included 375 primary care physicians and 375 nurse practitioners/physician assistants. Participants were screened to ensure that they treat ≥15 AR sufferers per month during allergy season. The majority of HCPs (86%) agreed that AR patients can easily recognize allergy symptoms after diagnosis and that 57% of their patients come to them self-recognizing their symptoms. A total of 82% strongly agreed that AR sufferers are primarily diagnosed via history and physical and do not typically undergo diagnostic testing until after pharmacologic intervention. HCPs reported that 63-77% of AR sufferers can easily manage AR once treatment is established. According to surveyed HCPs, OTC medication should precede an Rx medication for AR management. A total of 82% HCPs considered intranasal steroids (INSs) to be the gold standard AR treatment and have minimal safety concerns about INS use. HCPs perceive that patients can easily recognize and self-manage their AR symptoms. Patient history/symptoms and physical examination are the primary methods of AR diagnosis. INSs are considered the gold standard for treatment of AR. However, most HCPs feel OTC medication should be tried before Rx medication for AR management.

Insights on allergic rhinitis from the patient perspective.

Although intranasal steroid sprays are the preferred treatment of the majority of health care providers, this opinion is not carried through to patient treatment. Approximately two-thirds of adults with nasal allergy symptoms report that they use over-the-counter, nonprescription medicines, and only one-third report that they use an intranasal steroid spray. Lack of familiarity and poor patient awareness are key barriers to intranasal steroid spray use. Dissatisfaction related to side effects among users of these medications leads some of those who are familiar with intranasal steroid sprays to discontinue use after it has been prescribed. Improved health care provider­patient communication and education is a vital step toward improving the long-term management of allergic rhinitis.

Treatment of congestion in upper respiratory diseases.

Congestion, as a symptom of upper respiratory tract diseases including seasonal and perennial allergic rhinitis, acute and chronic rhinosinusitis, and nasal polyposis, is principally caused by mucosal inflammation. Though effective pharmacotherapy options exist, no agent is universally efficacious; therapeutic decisions must account for individual patient preferences. Oral H(1)-antihistamines, though effective for the common symptoms of allergic rhinitis, have modest decongestant action, as do leukotriene receptor antagonists. Intranasal antihistamines appear to improve congestion better than oral forms. Topical decongestants reduce congestion associated with allergic rhinitis, but local adverse effects make them unsuitable for long-term use. Oral decongestants show some efficacy against congestion in allergic rhinitis and the common cold, and can be combined with oral antihistamines. Intranasal corticosteroids have broad anti-inflammatory activities, are the most potent long-term pharmacologic treatment of congestion associated with allergic rhinitis, and show some congestion relief in rhinosinusitis and nasal polyposis. Immunotherapy and surgery may be used in some cases refractory to pharmacotherapy. Steps in congestion management include (1) diagnosis of the cause(s), (2) patient education and monitoring, (3) avoidance of environmental triggers where possible, (4) pharmacotherapy, and (5) immunotherapy (for patients with allergic rhinitis) or surgery for patients whose condition is otherwise uncontrolled.

Assessment of Patient Attitudes About Mometasone Furoate Nasal Spray: The Ease-of-Use Patient Survey.

BACKGROUND: : Intranasal corticosteroids (INS) are recommended as first-line therapy for allergic rhinitis. To date, no studies have evaluated the impact of an INS delivery system on patient satisfaction. Unless patients use a medication appropriately and consistently, they will not fully benefit from its therapeutic effects. OBJECTIVE: : To determine whether the characteristics of the mometasone furoate nasal spray (MFNS) delivery device are an impediment to its use. METHODS/DATABASE:: A random sample of preidentified MFNS users was recruited through e-mail (N = 1544). In online interviews, participants were asked about MFNS ease of use and attributes. RESULTS: : Ninety-eight percent of respondents reported that MFNS is easy to use, and 96% said that the applicator is easy to administer. Nearly all elderly users and users with arthritis said that the applicator fits comfortably in the nostril (96% and 97%, respectively) and is appropriately sized (97% and 96%, respectively); 96% of pediatric users agreed that the applicator fits comfortably. All users said the applicator's ease of use and comfortable fit were its most important attributes. CONCLUSIONS: : The perceived ease of use of MFNS may help providers appropriately treat patients with allergic rhinitis and may improve patient adherence to INS use.

Treatment options for the management of perennial allergic rhinitis, with a focus on intranasal corticosteroids.

Perennial allergic rhinitis (PAR) can have a significant impact on a patient's quality of life. While allergen avoidance is the first line of management for PAR, complete avoidance is difficult. Therapeutic options available for PAR include intranasal corticosteroids (INS), H1-antihistamines, decongestants and local chromones, as well as immunotherapy. For mild symptoms, INS and antihistamines are the standard of care, whereas for moderate-to-severe PAR, INS are the preferred therapy due to their proven efficacy. Patient quality of life and therapy preference play a role in maintaining adherence to treatment.