Impact of allergic rhinitis on the day-to-day lives of children: insights from an Australian cross-sectional study

Sinthia Bosnic-Anticevich; Peter Smith; Michael Abramson; Charlotte Mary Hespe; Menai Johnson; Rodney Stosic; David B Price

doi:10.1136/bmjopen-2020-038870

Impact of allergic rhinitis on the day-to-day lives of children: insights from an Australian cross-sectional study

BMJ Open. 2020 Nov 24;10(11):e038870. doi: 10.1136/bmjopen-2020-038870.

Authors

Sinthia Bosnic-Anticevich¹, Peter Smith², Michael Abramson³, Charlotte Mary Hespe⁴, Menai Johnson⁵, Rodney Stosic⁶, David B Price^{7

8}

Affiliations

¹ Department Lead, Quality Use of Medicines Group, Woolcock Institute of Medical Research, University of Sydney, Sydney Local Health District, Sydney, New South Wales, Australia Sinthia.Bosnic-Anticevich@sydney.edu.au.
² Professor of Clinical Medicine, Griffith University, Southport, Queensland, Australia.
³ Professor of Clinical Epidemiology, School of Public Health and Preventive Medicine, Monash University and Honorary Medical Officer in Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia.
⁴ General Practitioner & Head of Primary Care Research, University of Notre Dame, Australia (Sydney School of Medicine), Sydney & Director Asthma Foundation, Sydney, New South Wales, Australia.
⁵ Head of Central Medical Operations, Real World Clinical Evidence, Sanofi Australia/New Zealand, Sydney, New South Wales, Australia.
⁶ Formerly Head of Medical Affairs, Sanofi Consumer Healthcare, Sydney, New South Wales, Australia.
⁷ Managing Director, Observational and Pragmatic Research Institute, Singapore.
⁸ Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.

Abstract

Study design and objective: Cross-sectional, observational survey to describe the impact of allergic rhinitis (AR) on Australian children (2 to 15 years).

Methods: Participants (n=1541), parents of children aged 2 to 15 years, provided information on behalf of themselves and one eligible child in their household using a custom-built online questionnaire. Children were allocated to case (AR) or control (No AR) analysis groups based on a validated screening questionnaire.

Statistical methods: The study sample was stratified on age: primary analysis population (6 to 15 years, n=1111; AR=797, No AR=314); exploratory population (2 to 5 years). The primary endpoint, parent-perceived burden, was quantified using a validated measure of health status and analysed via comparison of means.

Results: The majority of AR cases were treated (730/797; 90.3%) and classified as having moderate-severe, intermittent AR (549/797; 68.9%). Half reported adequate symptom control in the prior 2 weeks (389/797; 48.8%; OR=4.04; 95% CI (CI) 2.24 to 7.31). Having AR was associated with worse overall health status (7.4 vs 8.4, mean difference (least squares mean difference (LSMD))=-0.99; 95% CI -1.18 to -0.79), fewer days being happy (22.2 vs 25.9, LSMD=-3.68; 95% CI -4.82 to -2.54) and more days of poor physical (2.82 vs 0.78, LSMD=2.04; 95% CI 1.61 to 2.47) and emotional (2.14 vs 0.67, LSMD=1.47; 95% CI 1.02 to -1.92) health compared with not having AR. All of these outcomes were significantly (p<0.05) worse in children who reported inadequate symptom control. Having AR negatively impacted on schoolwork, sleep and other activities, and increased the likelihood of having comorbidities.

Conclusion: The parent-perceived burden of AR in Australian children is high and it impacts many areas of day-to-day living. Inadequate symptom control is a key driver of the extent of this impact. Opportunities to optimise the management of AR in children include the adoption of self-assessment tools to gauge and monitor adequacy of symptom control.

Keywords: allergy; paediatric thoracic medicine; quality in health care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Australia / epidemiology
Child
Child, Preschool
Comorbidity
Cross-Sectional Studies
Humans
Quality of Life
Rhinitis, Allergic* / epidemiology
Surveys and Questionnaires