Abstract
Background: Allergic rhinitis (AR) and asthma are often co-morbidities. The correct management of AR should be ensured by the use of international ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines (GL).
Aim: To prospectively evaluate the adherence to GL of General Practitioners (GPs) for treating AR patients.
Methods: Analyses concern 1197 patients (14-90 years, median 37) of 107 Italian GPs. Evaluation of appropriateness was based on ARIA GL, according to AR classification.
Results: 44% of patients had concomitant asthma diagnosis. Among the 84 patients with moderate-severe persistent AR, 24% (18% of 40 with concomitant asthma) were prescribed antihistamines monotherapy. Among the 553 patients with mild-intermittent AR, 42% (36% of 332 with only AR) were prescribed combined therapies. In general, the adherence to GL was 57% for patients with only AR and 46% for those with AR+asthma (p < 0.001). The adherence increased with increasing AR severity and reached 81% for the patients with moderate-severe persistent AR (89 and 95% for those with only AR or AR+asthma, respectively).
Conclusions: GL recommendations are not fully applied within the clinical practice. The adherence to ARIA GL is higher for treating more severe AR. These findings underscore the need to monitor the implementation of clinical practice guidelines among GPs with the attempt to improve their compliance.
This work was supported by the Italian Agency of Drug (AIFA), project no. FARMJY5SA “Respiratory allergic diseases: monitoring study of GINA and ARIA guidelines (ARGA)”.
- © 2011 ERS