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

Authors

Baharudin Abdullah Department of Otorhinolaryngology – Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan https://orcid.org/0000-0001-9138-9215
Kornkiat Snidvongs Endoscopic Nasal and Sinus Surgery Excellence Center Chulalongkorn Hospital, Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University https://orcid.org/0000-0001-7537-4718
Marysia Recto Adult and Pediatric Division of Allergy and Immunology, University of the Philippines - Philippine General Hospital, Manila https://orcid.org/0000-0001-6818-8888
Niken Lestari Poerbonegoro Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta
De Yun Wang Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore

DOI: https://doi.org/10.4081/mrm.2020.726

Keywords:

Allergic rhinitis, management, ASEAN, primary care, general practitioners, multidisciplinary

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

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