Dissonance Between Patients’ and Physicians’ Perceptions of Allergic Rhinitis and Effects of Medications

The largest survey to date of patients with allergic rhinitis (AR) and physicians who treat them revealed that patients’ and physicians’ perceptions of this disorder are not always in sync. Physicians thought that patients were more satisfied with their medications and their quality of life (QOL) than they were; a sizable proportion of patients reported that their medications either did not work well or worked at first but lost effectiveness over time. Two-thirds of respondents said that AR compromised quality of life. Further, more patients reported more year-round symptoms than seasonal symptoms, although AR has been assumed to be seasonal.

Robert Naclerio, MD

These findings imply that physicians who treat patients with AR should be more mindful about the dissatisfactions and suffering associated with these allergies. We are not doing a good enough job in communicating with patients about the results of treatment. Many physicians consider allergies a minor problem and downplay them. However, allergies have a huge impact on quality of life. The survey revealed that physicians need to pay more attention to AR symptoms and their impact on quality of life. We need to use appropriate methods to evaluate patients and prescribe medications that effectively control symptoms that interfere with quality of life, said James Hadley, MD, Associate Professor of Otolaryngology at the University of Rochester Medical Center in Rochester, NY.

The survey, conducted in January 2006, included 2500 patients who received a diagnosis of AR from a physician and who were symptomatic within the past year. The patient survey was carried out by structured 35-minute telephone interviews with respondents with AR who were questioned about allergies, severity and frequency of symptoms, and satisfaction with treatment. The survey also included a separate physicians’ section that included 300 US physicians who provide direct patient care in an outpatient setting (100 primary care physicians, 100 allergists, and 100 otolaryngologists). During structured 20-minute interviews, physicians were asked about the burden of AR on patients diagnosed by a physician as having AR and symptomatic during the past year, their treatment algorithm for AR management, and their perceptions of patient satisfaction with treatment.

Unexpected Findings

According to M. Jennifer Derebery, MD, who is an associate at the House Clinic and Institute and Clinical Professor of Otolaryngology at USC Keck School of Medicine in Los Angeles, the survey revealed two major surprises. One was that a higher percentage of patients reported perennial symptoms of AR than has been found in the past; 56% of patients had symptoms all year long, while 44% reported seasonal AR.