Impact of Allergic Rhinitis Symptoms on Quality of Life in Primary CareBousquet P.J.a · Demoly P.b · Devillier P.c · Mesbah K.d · Bousquet J.a, e
aUniversity Hospital, and bINSERM U657, CHU de Montpellier, Montpellier, cUPRES EA 220, Hôpital Foch, Université de Versailles Saint Quentin, Suresnes, dMSD France, Courbevoie, and eINSERM U 1018, Paris, France
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Article / Publication Details
Background: Allergic rhinitis (AR) impairs quality of life (QoL), sleep and work. The Allergic Rhinitis and its Impact on Asthma (ARIA) classification is widely used, but the impact of the different symptoms on QoL is not clear. Objective: To describe characteristics of patients consulting in primary care for AR and to study the impact of AR symptoms and the ARIA classes on QoL. Methods: A multicenter prospective observational cross-sectional study assessed the visual analogue scale (VAS) in the management of AR in 990 patients consulting general practitioners for AR. Patients were classified according to the four classes of ARIA. VAS, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and total symptom score (TSS) for nasal and non-nasal symptoms were evaluated. VAS and TSS measures were compared with RQLQ. Results: Mild intermittent rhinitis was diagnosed in 20% of patients, mild persistent rhinitis in 17%, moderate/severe intermittent rhinitis in 15% and moderate/severe persistent rhinitis in 48%. The presence of treatments did not affect VAS levels. Both severity and duration of rhinitis had an impact on QoL and VAS levels. Ocular symptoms (OR: 2.78, 95% CI: 1.965–3.939) including eyelid edema (OR: 2.07, 95% CI: 1.274–3.360) and asthenia (OR: 2.73, 95% CI: 1.922–3.877) had more impact on RQLQ than nasal obstruction (OR: 1.61, 95% CI: 1.078–2.405) and nasal pruritus (OR 1.45, 95% CI: 1.028–2.042). Sneezing and rhinorrhea did not impact RQLQ. Conclusions: This study confirmed that ocular symptoms and, to a lesser degree, nasal obstruction and pruritus have a significant impact on QoL.
© 2012 S. Karger AG, Basel
- Bousquet J, Van Cauwenberge P, Khaltaev N: Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001;108(suppl 5):S147–S334.
- Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al: Allergic rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008;63(suppl 86):8–160.
- Demoly P, Allaert FA, Lecasble M, Bousquet J: Validation of the classification of ARIA (allergic rhinitis and its impact on asthma). Allergy 2003;58:672–675.
- Ciprandi G, Cirillo I, Vizzaccaro A, Tosca M, Passalacqua G, Pallestrini E, et al: Seasonal and perennial allergic rhinitis: is this classification adherent to real life? Allergy 2005;60:882–887.
- Bousquet J, Neukirch F, Bousquet PJ, Gehano P, Klossek JM, Le Gal M, et al: Severity and impairment of allergic rhinitis in patients consulting in primary care. J Allergy Clin Immunol 2006;117:158–162.
- Bachert C, van Cauwenberge P, Olbrecht J, van Schoor J: Prevalence, classification and perception of allergic and nonallergic rhinitis in Belgium. Allergy 2006;61:693–698.
- Valero A, Baro E, Sastre J, Navarro-Pulido AM, Izquierdo I, Marti-Guadano E, et al: Reference values for facilitating the interpretation of the ESPRINT-15 questionnaire (Spanish version). J Investig Allergol Clin Immunol 2009;19:396–403.
- Bousquet PJ, Bousquet-Rouanet L, Co Minh HB, Urbinelli R, Allaert FA, Demoly P: ARIA (Allergic Rhinitis and Its Impact on Asthma) classification of allergic rhinitis severity in clinical practice in France. Int Arch Allergy Immunol 2007;143:163–169.
- Demoly P, Concas V, Urbinelli R, Allaert FA: Spreading and impact of the World Health Organization’s Allergic Rhinitis and its Impact on Asthma Guidelines in everyday medical practice in France. Ernani survey. Clin Exp Allergy 2008;38:1803–1807.
- Jauregui I, Davila I, Sastre J, Bartra J, del Cuvillo A, Ferrer M, et al: Validation of ARIA (Allergic Rhinitis and its Impact on Asthma) classification in a pediatric population: the PEDRIAL study. Pediatr Allergy Immunol 2011;22:388–392.
- Van Hoecke H, Vastesaeger N, Dewulf L, De Bacquer D, van Cauwenberge P: Is the allergic rhinitis and its impact on asthma classification useful in daily primary care practice? J Allergy Clin Immunol 2006;118:758–759.
- Valero A, Ferrer M, Sastre J, Navarro AM, Monclus L, Marti-Guadano E, et al: A new criterion by which to discriminate between patients with moderate allergic rhinitis and patients with severe allergic rhinitis based on the Allergic Rhinitis and its Impact on Asthma severity items. J Allergy Clin Immunol 2007;120:359–365.
del Cuvillo A, Montoro J, Bartra J, Valero A, Ferrer M, Jauregui I, et al: Validation of ARIA duration and severity classifications in Spanish allergic rhinitis patients – the ADRIAL cohort study. Rhinology 2010;48:201–205.
- Bousquet PJ, Combescure C, Neukirch F, Klossek JM, Mechin H, Daures JP, et al: Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines. Allergy 2007;62:367–372.
- Bousquet PJ, Bachert C, Canonica GW, Casale TB, Mullol J, Klossek JM, et al: Uncontrolled allergic rhinitis during treatment and its impact on quality of life: a cluster randomized trial. J Allergy Clin Immunol 2010;126:666–668.
- Bousquet PJ, Combescure C, Klossek JM, Daures JP, Bousquet J: Change in visual analog scale score in a pragmatic randomized cluster trial of allergic rhinitis. J Allergy Clin Immunol 2009;123:1349–1354.
- Bousquet J, Bachert C, Canonica GW, Mullol J, Van Cauwenberge P, Bindslev Jensen C, et al: Efficacy of desloratadine in intermittent allergic rhinitis: a GALEN study. Allergy 2009;64:1516–1523.
- Bousquet J, Bachert C, Canonica GW, Mullol J, Van Cauwenberge P, Jensen CB, et al: Efficacy of desloratadine in persistent allergic rhinitis – a GA(2)LEN study. Int Arch Allergy Immunol 2010;153:395–402.
- Smith AF, Pitt AD, Rodruiguez AE, Alio JL, Marti N, Teus M, et al: The economic and quality of life impact of seasonal allergic conjunctivitis in a Spanish setting. Ophthalmic Epidemiol 2005;12:233–242.
- Virchow JC, Kay S, Demoly P, Mullol J, Canonica W, Higgins V: Impact of ocular symptoms on quality of life (QoL), work productivity and resource utilisation in allergic rhinitis patients – an observational, cross sectional study in four countries in Europe. J Med Econ 2011;14:305–314.
- Lu D, Zhao Y, Zheng Y, An P, Wang L, Qiao X, et al: Evaluation of quality of life questionnaires for adult patients with moderate to severe allergic rhinitis. Am J Otolaryngol 2011;32:494–498.
Valero A, Mullol J, Herdman M, Rosales MJ: Measuring outcomes in allergic rhinitis: psychometric characteristics of a Spanish version of the congestion quantifier seven-item test (CQ7). Health Qual Life Outcomes 2011;9:14.
- Bousquet J, Annesi-Maesano I, Carat F, Leger D, Rugina M, Pribil C, et al: Characteristics of intermittent and persistent allergic rhinitis: DREAMS study group. Clin Exp Allergy 2005;35:728–732.
- Valero A, Ferrer M, Baro E, Sastre J, Navarro AM, Marti-Guadano E, et al: Discrimination between moderate and severe disease may be used in patients with either treated or untreated allergic rhinitis. Allergy 2010;65:1609–1613.
- Siroux V, Boudier A, Bousquet J, Bresson JL, Cracowski JL, Ferran J, et al: Phenotypic determinants of uncontrolled asthma. J Allergy Clin Immunol 2009;124:681–687.
- Bousquet J, Fokkens W, Burney P, Durham SR, Bachert C, Akdis CA, et al: Important research questions in allergy and related diseases: nonallergic rhinitis: a GA2LEN paper. Allergy 2008;63:842–853.
- Di Lorenzo G, Pacor ML, Amodio E, Leto-Barone MS, La Piana S, D’Alcamo A, et al: Differences and similarities between allergic and nonallergic rhinitis in a large sample of adult patients with rhinitis symptoms. Int Arch Allergy Immunol 2011;155:263–270.
- Costa DJ, Amouyal M, Lambert P, Ryan D, Schunemann HJ, Daures JP, et al: How representative are clinical study patients with allergic rhinitis in primary care? J Allergy Clin Immunol 2011;127:920–926.
- Bousquet PJ, Cropet C, Klossek JM, Allaf B, Neukirch F, Bousquet J: Effect of smoking on symptoms of allergic rhinitis. Ann Allergy Asthma Immunol 2009;103:195–200.
- Juniper EF, Guyatt GH: Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis. Clin Exp Allergy 1991;21:77–83.
- Leger D, Annesi-Maesano I, Carat F, Rugina M, Chanal I, Pribil C, et al: Allergic rhinitis and its consequences on quality of sleep: an unexplored area. Arch Intern Med 2006;166:1744–1748.
- Ohta K, Bousquet PJ, Aizawa H, Akiyama K, Adachi M, Ichinose M, et al: Prevalence and impact of rhinitis in asthma. SACRA, a cross-sectional nation-wide study in Japan. Allergy 2011;66:1287–1295.
- Schatz M, Meltzer EO, Nathan R, Derebery MJ, Mintz M, Stanford RH, et al: Psychometric validation of the rhinitis control assessment test: a brief patient-completed instrument for evaluating rhinitis symptom control. Ann Allergy Asthma Immunol 2010;104:118–124.
- Demoly P, Jankowski R, Chassany O, Bessah Y, Allaert FA: Validation of a self-questionnaire for assessing the control of allergic rhinitis. Clin Exp Allergy 2011;41:860–868.
- Guilemany JM, Garcia-Pinero A, Alobid I, Cardelus S, Centellas S, Bartra J, et al: Persistent allergic rhinitis has a moderate impact on the sense of smell, depending on both nasal congestion and inflammation. Laryngoscope 2009;119:233–238.
- Bousquet J, Lund VJ, Van Cauwenberge P, Bremard-Oury C, Mounedji N, Stevens MT, et al: Implementation of guidelines for seasonal allergic rhinitis: a randomized controlled trial. Allergy 2003;58:733–741.
- Bousquet J, Bodez T, Gehano P, Klossek JM, Liard F, Neukirch F, et al: Implementation of guidelines for allergic rhinitis in specialist practices: a randomized pragmatic controlled trial. Int Arch Allergy Immunol 2009;150:75–82.
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