EVALUATION OF EFFICACY OF MANAGEMENT PROTOCOL IN ALLERGIC RHINITIS

Authors

  • Shahid Ali Shah
  • Tahira Sajid
  • Muhammad Asif
  • Farida Khan
  • Tahir Haroon
  • Sohail Malik
  • Rehman Ghani

Abstract

Background: Allergic rhinitis represents a global health issue affecting between 10% to 25% ofthe world population, with increasing prevalence, resulting in a significant impact on quality oflife, multiple comorbidities and the considerable socio-economic burden. Majority of the patientsare younger than 30 years and it may be inherited. Symptoms typically occur as a result ofexposure to dust, dander or certain seasonal pollen. Lack of standardized management protocol isone of the major factors responsible for poor control of this condition. This study was designed toevaluate the patients suffering with allergic rhinitis and manage them with a protocol based on thepathogenesis of the condition. Method: This prospective study was conducted in the Departmentof Ear, Nose & Throat and Head & Neck Surgery, Ayub Teaching Hospital, Abbottabad, over aperiod of two years (2005 – 2006), to assess the efficacy of a standard protocol of treatmentdeveloped and followed in the department. 1167 patients, clinically diagnosed as suffering withallergic rhinitis, were evaluated and managed. Age ranged from 08 months to 64 years. All thepatients were prescribed medical treatment, divided into initial phase of 10 days to two weeksduration followed by a maintenance phase, and a regular follow-up schedule was maintained uptotwo years. Results: 634 (54.32%) patients were male and 533 (45.67%) were female. Age rangedfrom 08 months to 64 years, 85% being between 05 and 45 years. 91% of patients had symptomduration of 06 months to 03 years. 96% of the patients were getting treated on as required basis,whereas 98% had no educational sessions with the treating doctor, especially regarding preventivemeasures. Typical presentation in most of the patients was nasal obstruction, runny & itchy nose,post nasal drip and bouts of sneezing. 90.57% patients reported improvement in symptoms.53.21% patients had a relapse of symptoms at some stage during the study period. 37.53% patientshad surgery done for associated pathologies, mostly a DNS. Compliance regarding medicationwas more than 90% in the initial phase of treatment that dropped to 50% in the maintenance phase.93% of the patients tolerated the treatment well. Conclusion: Allergic rhinitis is a growingproblem worldwide. Optimal treatment protocol is still lacking especially in the developingcountries. Patient’s education on avoidance of allergens must be stressed. Associated problemsthat may need surgical treatment. Regular follow-up must be ensured to monitor the progress oftreatment as well as to identify patients who might be candidates for immunotherapy. Newermodalities of treatment need to be further explored. A team approach is mandatory in the presenceof symptoms related to lower respiratory tract.Key words : Allergic rhinitis; Treatment; Antihistamine; Intranasal corticosteroid; Surgery

References

Hussain I, Kline JN. DNA, the immune system, and atopic

disease. J Investig Dermatol Symp Proc 2004;9(1):23-8.)

Salib RJ, Drake-Lee A, HowarthPH. Allergic rhinitis: past,

present and the future. Clin Otolaryngol Allied Sci 2003;

(4):291-303.

Elango S. Recent trends in the diagnosis and management of

allergic rhinitis Med J Malaysia 2005;60(5):672-6.

Galant SP , Wilkinson R . Clinical prescribing of allergic

rhinitis medication in the preschool and young school-age

child: what are the options? BioDrugs 2001;15(7):453-63.

Van Cauwenberge P, Van Hoecke H. Management of allergic

rhinit is. B-ENT 2005;Suppl 1:45-62.

Peroni DG, Piacentini GL, Bodini A, Rigotti E, Pigozzi R,

Boner AL.Prevalence and risk factors for atopic dermatitis in

preschool children. Br J Dermatol 2007. [Epub ahead of

print]

Allison C, Fraser J. Grazax: an oral vaccine for the treatment

of grass pollen allergy (hay fever). Issues Emerg Health

Technol 2007;(107) :1-4.

Stafford CT . Allergic rhinitis. A useful guide to diagnosis

and treatment.Postgrad Med1987;;81(1):147-51.

9.Rosenwasser LJ. Treatment of allergic rhinitis. Am J Med

; 16:113.

Hadley JA. Evaluation and management of allergic rhinitis.

Med Clin North Am 1999;83(1):13-25.

Van Hoecke H, Vandenbulcke L , Van Cauwenberge P .

Histamine and leukotriene receptor antagonism in the

treatment of allergic rhinitis : an update. Drugs 2007;67(18):

-26.

Smith LJ. Diagnosis and treatment of allergic rhinitis. Nurse

Pract 1995;20(10):58-60.

Scadding GK. Corticosteroids in the treatment of pediatric

allergic rhinitis. J Allergy Clin Immunol2001;108(1 Suppl):

S59-64.

Reichmuth D, Lockey RF. Present and potential therapy for

allergic rhinitis: a review. Bio Drugs 2000;14(6):371-87.

Grossman J, Banov C, Bronsky EA, Nathan RA, Pearlman D,

Winder JA et al. Fluticasone propionate aqueous nasal spray

is safe and effective for children with seasonal allergic

rhinitis. Pediatrics 1993;92(4):594-9.

Koreck AI, Csoma Z , Bodai L , Ignacz F, Kenderessy AS,

Kadocsa E et al. Rhinophototherapy: a new therapeutic tool

for the management of allergic rhinitis. J Allergy Clin

Immunol2005;115(3):541-7.

Downloads

Most read articles by the same author(s)

<< < 1 2 3 4 > >>