Primary care management of allergic rhinitis: a cross-sectional study in four ASEAN countries

Baharudin Abdullah; Kornkiat Snidvongs; Marysia Recto; Niken Lestari Poerbonegoro; De Yun Wang

doi:10.4081/mrm.2020.726

Primary care management of allergic rhinitis: a cross-sectional study in four ASEAN countries

Multidiscip Respir Med. 2020 Dec 11;15(1):726. doi: 10.4081/mrm.2020.726. eCollection 2020 Jan 28.

Authors

Baharudin Abdullah¹, Kornkiat Snidvongs², Marysia Recto³, Niken Lestari Poerbonegoro⁴, De Yun Wang⁵

Affiliations

¹ Department of Otorhinolaryngology - Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
² Endoscopic Nasal and Sinus Surgery Excellence Center Chulalongkorn Hospital, Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Thailand.
³ Adult and Pediatric Division of Allergy and Immunology, University of the Philippines - Philippine General Hospital, Manila, Philippenes.
⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta.
⁵ Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Abstract

Background: In primary care, general practitioners (GPs) and pharmacists are tasked with the frontline responsibility of identifying and managing allergic rhinitis (AR) patients. There are currently no consolidated data on current treatment practices, patient compliance, and usage of guidelines within Southeast Asian Nations (ASEAN). Objective: To assess the attitudes and practices on AR of GPs and pharmacists in 4 ASEAN countries (Philippines, Indonesia, Thailand, and Malaysia).

Methods: A cross-sectional survey of 329 GPs and 548 pharmacists was conducted from May to November 2019. Participants answered a questionnaire focused on their i) current practice in the management of AR, ii) views on patient compliance, iii) understanding and usage of guidelines.

Results: Clinical history was the most preferred method to diagnose AR by 95.4% of GPs and 58.8% of pharmacists. Second-generation antihistamines were the most widely available treatment option in GP clinics and pharmacies (94.8% and 97.2%) and correspondingly the most preferred treatment for both mild (90.3%, 76.8%) to moderatesevere rhinitis (90.3%, 78.6%) by GPs and pharmacists, respectively. Loratadine was ranked as the most preferred 2^nd generation antihistamines (GP vs pharmacists: 55.3% vs 58.9%). More than 90% of GPs and pharmacists ranked length and efficacy of treatment as important factors that increase patient compliance. Awareness of the ARIA guidelines was high among GPs (80%) and lower among pharmacists (48.4%). However, only 63.3% of GPs and 48.2% of pharmacists knew how to identify AR patients.

Conclusions: The survey in the 4 ASEAN countries has identified a need to strengthen the awareness and use of ARIA guidelines among the primary care practitioners. Adherence to ARIA guidelines, choosing the appropriate treatment option and prioritizing factors that increases patient compliance may contribute to better management outcomes of AR at the primary care practice.

Keywords: ASEAN; Allergic rhinitis; general practitioners; management; multidisciplinary; primary care.