Asthma with allergic rhinitis management in China: a nationwide survey of respiratory specialists at tertiary hospitals

Int Forum Allergy Rhinol. 2015 Mar;5(3):221-32. doi: 10.1002/alr.21449. Epub 2014 Nov 15.

Abstract

Background: Many asthmatic patients have coexisting allergic rhinitis (AR). This study aims to investigate the compliance of physicians with respiratory medicine specialty (PRMs) to Global Initiative for Asthma (GINA) and Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines during the management of their asthma-AR patients.

Methods: This cross-sectional questionnaire study surveyed the diagnostic methods and treatment patterns for asthma-AR comorbidity by PRMs from 98 hospitals across China.

Results: PRMs reported an estimated prevalence of asthma-AR comorbidity of >30% at their clinics. PRMs with greater work experience and a higher professional title estimated treating a significantly higher proportion of patients with AR within the previous month (p = 0.002 and p < 0.001, respectively); they also estimated a higher incidence of patients with AR in the autumn (p < 0.001 and p < 0.001). A higher percentage of PRMs with ≥11 years work experience prescribed nasal steroids for AR as compared to those with 1 to 10 years experience (56.9% vs 44.7%, p = 0.002). A greater proportion of chief physicians used leukotriene modifiers and a lower proportion used antihistamine H1 -receptor blockers for AR as compared to residents (resident vs assistant chief: 27.5% vs 11.6%, p = 0.002; and resident vs chief PRMs: 27.5% vs 9.5%, p = 0.001).

Conclusion: PRMs in China demonstrated an up-to-date comprehension of asthma management (>90%); however, knowledge gaps existed in their concepts of AR and asthma-AR comorbidity. Thus, further education is warranted for PRMs regarding the importance of AR in asthma patients, definitive diagnosis (allergy tests), classifications of AR, and treatment guidelines for the asthma-AR comorbidity.

Keywords: ARIA; China; GINA; allergic rhinitis; asthma; asthma-allergic rhinitis comorbidity; disease management.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • China
  • Cross-Sectional Studies
  • Female
  • Guideline Adherence
  • Histamine Antagonists / therapeutic use
  • Humans
  • Leukotriene Antagonists / therapeutic use
  • Male
  • Nasal Decongestants / therapeutic use
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Pulmonary Medicine / statistics & numerical data*
  • Rhinitis, Allergic / diagnosis
  • Rhinitis, Allergic / drug therapy*
  • Seasons
  • Steroids / therapeutic use

Substances

  • Anti-Asthmatic Agents
  • Histamine Antagonists
  • Leukotriene Antagonists
  • Nasal Decongestants
  • Steroids