Insights on allergic rhinitis from the patient perspective

FIGURE 1

(A) Nasal allergy triggers and (B) effect on nasal allergy symptoms

Respondents were asked: (A) What things usually trigger or make your nasal allergy symptoms worse? (B) Do these triggers usually make your allergy symptoms a lot worse, moderately worse, or only a little worse than normal?

Base: All respondents, unweighted, N = 400.

Preferred Classes of Medications for Nasal Allergy Symptoms

Results of the HCP survey clearly showed that prescription intranasal steroid sprays or inhaled corticosteroids are the preferred choice of most HCPs (all HCPs, 67%: allergists, 94%; otolaryngologists, 68%; primary care physicians [PCPs], 67%; NP/PAs, 40%) for adults with moderate to severe persistent allergy symptoms. This preference was supported by the fact that virtually all HCPs said that they believe the benefits probably or definitely outweigh the drawbacks of intranasal steroid sprays for the management of nasal allergies. Only a very small proportion of PCPs (4%) and NP/PAs (6%) said that the drawbacks probably or definitely outweigh the benefits in the management of nasal allergies.

By contrast, although the vast majority of patients (83%) reported taking some type of medication for their nasal allergies in the past 4 weeks, only 30% reported using an intranasal steroid spray. Instead, 62% of patients reported using over-the-counter (OTC), nonprescription medicine, 25% reported using some other type of prescription medication, and 17% reported that they took none of these types of medication (FIGURE 2).

FIGURE 2

Medications used by the patient in the preceding 4 weeks

Patients were asked: (A) In the past 4 weeks have you used any over-the-counter, nonprescription medicine to relieve your nasal allergy symptoms? (B) In the past 4 weeks have you used any intranasal steroid spray for your nasal allergy symptoms? (C) Have you taken any (other) prescription medications for your nasal allergies in the past 4 weeks?

Base: All respondents, unweighted, N = 400.

Perceived Control of Nasal Allergies

Although the majority of allergy sufferers reported being at least somewhat bothered by nasal congestion and sneezing in the past week, most patients (53%) described their allergies as completely controlled or well controlled in the past week. On the other hand, 36% of respondents said that their allergies were somewhat controlled in the last week, and 11% described their allergies in the last week as poorly controlled or not controlled at all (FIGURE 3A).

In contrast to the patients' report, HCPs were generally less positive about how well controlled their patients' nasal allergies were. Almost one-third of HCPs (all HCPs, 28%: allergists, 34%; otolaryngologists, 26%; PCPs, 25%; NP/PAs, 30%) felt that all or most of their patients with nasal allergies would be classified as completely controlled or well controlled in May or June. Most HCPs (all HCPs, 53%: allergists, 44%; otolaryngologists, 62%; PCPs, 53%; NP/PAs, 56%) felt that some of their patients with nasal allergies would be classified as completely controlled or well controlled in May or June. Surprisingly, a small number of HCPs (all HCPs, 17%: allergists, 22%; otolaryngologists, 12%; PCPs, 19%; NP/ PAs, 12%) felt that few or none of their patients have completely controlled or well-controlled allergies in May or June (FIGURE 3B).

FIGURE 3

Perceived control of nasal allergies symptoms: (A) patient perspective and (B) health care provider perspective

(A) Patients were asked: Overall, how well would you say that your nasal allergies have been controlled in the last week? Would you say they were completely controlled, well controlled, somewhat controlled, poorly controlled, or not controlled at all?

Base: All respondents, unweighted, N = 400.

(B) Health care providers were asked: What proportion of your patients with nasal allergies would you classify as having completely controlled or well-controlled allergies in May or June? All (91%-100%), most (51%-90%), some (11%-50%), few (1%-10%), or none (0%)?

Base: All respondents, N = 250.

Patient Perceptions of Intranasal Steroid Sprays

There appeared to be many reasons why the physicians' preferred choice of AR medication was not always used in practice. First, 37% of AR patients reported that they were not too familiar, not at all familiar, or did not know how familiar they were with intranasal steroid sprays for nasal allergies. Of the 63% of AR patients who reported at least some familiarity with intranasal steroid sprays, nearly half (49%) said that they had heard intranasal steroid sprays relieved symptoms and 10% thought that intranasal steroid sprays reduced nasal swelling (FIGURE 4A). Patients who had some familiarity with intranasal steroid sprays were also asked what, if anything, bad they had heard for these drugs. The most commonly volunteered concerns were: they lead to nasal damage (15%), they were addictive (13%), there were side effects (12%), they contain steroids (8%), they are not effective (5%), and they cause headaches (4%) (FIGURE 4B). Further questioning revealed that the majority (64%) of these patients with nasal allergies said that, based on what they knew or had heard, the benefits of steroid nasal sprays definitely or probably outweighed the drawbacks, whereas 18% said that drawbacks of intranasal steroid sprays probably or definitely outweighed the benefits, and 18% were not sure.