Management of allergic rhinitis: a common part of practice in primary care clinics
Article first published online: 16 FEB 2004
Volume 59, Issue 3, pages 315–319, March 2004
How to Cite
Wang, D.-Y., Chan, A. and Smith, J. D. (2004), Management of allergic rhinitis: a common part of practice in primary care clinics. Allergy, 59: 315–319. doi: 10.1046/j.1398-9995.2003.00402.x
- Issue published online: 16 FEB 2004
- Article first published online: 16 FEB 2004
- Accepted for publication 25 August 2003
- allergic rhinitis;
- primary care clinic;
- international guidelines;
- evidence-based therapy
Background: Allergic rhinitis (AR) is an extremely common disease worldwide and one of the top-ten reasons for a visit to primary care clinics. This study aimed to investigate the understanding of current guidelines and concepts of management for AR among general practitioners (GPs) in Singapore.
Methods: A postal questionnaire was designed to survey the dispensing practice and understanding of current guidelines in the management of AR among Singapore GPs.
Results: Two hundred GPs completed the questionnaire. AR was estimated to be 10–40% of total patient visits in 50% of the primary care clinics surveyed. There was no significant difference in diagnosis and management of AR among GPs practicing solo, as a group or in polyclinics. The use of allergy tests (skin or in vitro tests) was <50%. Most physicians understood correctly the efficacy, side-effects, and cost effectiveness of first and newer generation H1-antihistamines and nasal glucocorticosteroids. However, first generation H1-antihistamines and oral/nasal decongestants are commonly used to reduce the cost of medication and to achieve quick relief from nasal obstruction.
Conclusion: Management of allergic rhinitis is common in primary care clinics. Quick symptomatic relief with low-cost medications is a major concern for GPs in the management of AR, as it will affect a patient's compliance and perception of efficacy. However, inappropriate use of decongestants and other nonevidence-based therapies should not be recommended. Implementing the current evidence-based international guidelines for AR needs to be improved.