Asia Pac Allergy.  2014 Jul;4(3):142-148. 10.5415/apallergy.2014.4.3.142.

The status quo and unmet needs in the management of allergic rhinitis and chronic rhinosinusitis: a Malaysian perspective

• Prepageran N
• Wang DY
• Nair G
• Maurer M

• KMID: 2397091
• DOI: http://doi.org/10.5415/apallergy.2014.4.3.142

Abstract

BACKGROUND
Allergic rhinitis and rhinosinusitis, common and debilitating conditions, should be managed in accordance with guideline recommendations. Guideline adherence shows regional differences. As of now, there is little data from Asia and none from Malaysia on the current treatment practices and unmet needs in the management of these conditions.
OBJECTIVE
The objective of this study was to assess the current practice in the management of allergic rhinitis and rhinosinusitis by conducting a survey among ear, nose and throat (ENT) specialists, pharmacists, and general practitioners (GPs) in Malaysia.
METHODS
We conducted a survey study among ENT specialists, pharmacists, and GPs in Malaysia, who answered a multiple choice questionnaire focused on the current practice in the management of allergic rhinitis and rhinosinusitis in their respective field. More than 200 ENT specialists, 100 pharmacists, and 200 GPs participated in the survey.
RESULTS
Antihistamines were the most preferred choice for the treatment of mild allergic rhinitis by ENT specialists (45%), pharmacists (78%), and GPs (51%), with the most preferable duration of <2 weeks. In moderate-to-severe allergic rhinitis, a combination of antihistamines and intranasal steroids was the most preferred treatment of choice in 90% of ENT specialists, 72% of pharmacists, and 69% of GPs. Efficacy of antihistamines was the main criteria of choice in 58%, 53%, and 38% of ENT specialists, pharmacists, and GPs, respectively. Notably, complaints of drowsiness associated with nonsedative antihistamines were the major unmet need identified in the survey. For chronic rhinosinusitis, a combination of antihistamines and intranasal steroids was the most preferred treatment. The majority of the respondents preferred a treatment duration of >3 months with antihistamines. Satisfaction with the recommendations in the current Allergic Rhinitis and its Impact on Asthma (ARIA) guideline was high; 66%, 58%, and 89% of the ENT specialists, pharmacists, GPs, respectively, reported that the current ARIA guidelines are sufficient for their clinical/pharmacy practice.
CONCLUSION
The current practices in the management of allergic rhinitis in Malaysia are largely in line with the ARIA guidelines. The majority of physicians and pharmacists are satisfied with the recommendations in the ARIA guidelines.

Keyword

Allergic rhinitis; Histamine antagonists; Professional practice; Pharmacists; General practitioners

MeSH Terms

Asia
Asthma
Ear
General Practitioners
Guideline Adherence
Histamine Antagonists
Humans
Malaysia
Nose
Pharmacists
Pharynx
Professional Practice
Rhinitis, Allergic*
Sleep Stages
Specialization
Steroids
Surveys and Questionnaires
Histamine Antagonists
Steroids

Figure

• 

  Fig. 1 (A) Preferred treatment of choice for mild allergic rhinitis. (B) Preferred treatment of choice for moderate-to-severe allergic rhinitis. (C) Preferred duration of treatment for antihistamines in mild allergic rhinitis. (D) Preferred duration of treatment for antihistamines in moderate-to-severe allergic rhinitis. ENT, ear, nose, and throat; PRN, as needed.

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  Fig. 2 Need for a change in Allergic Rhinitis and its Impact on Asthma guidelines. ENT, ear, nose, and throat.

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