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Medical care and treatment of allergic rhinitis. A population-based cohort study based on routine healthcare utilization data.

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Medical care and treatment of allergic rhinitis. A population-based cohort study based on routine healthcare utilization data.

Allergy. 2016 Jan 8;

Authors: Schmitt J, Stadler E, Küster D, Wüstenberg EG

Abstract
BACKGROUND: Health services research on medical care and treatment of allergic rhinitis (AR) is scarce.
OBJECTIVES: To investigate the prevalence, incidence, comorbidities, and treatment of AR in a realistic setting.
METHODS: A cohort of 1,811,094 German National Health Insurance beneficiaries in 2005 was followed until 2011. To avoid misclassification, the ICD-10-code for AR (J30) had to be documented at least twice to classify patients as having AR. Descriptive statistics and logistic regression models were used to describe the burden, comorbidities, and treatment of AR.
RESULTS: A total of 111,394 patients (6.2%) had prevalent AR in 2005/2006. In another 60,145 individuals (3.3%) AR was newly diagnosed in 2007 to 2011 (incident cases). Patients with prevalent AR were three times more likely to develop asthma compared to patients without AR (age and sex-adjusted risk ratio (RR) 3.04; 95% confidence interval (95%CI) 2.98 – 3.10). Newly diagnosed recurrent depressive disorder (RR 1.61; 95%CI 1.55 – 1.68), anxiety disorder (RR 1.52; 95%CI 1.48 – 1.56) and ADHD (RR 1.21; 95%CI 1.13 – 1.29) were also related to prevalent AR. Approximately 20% of children and 36% of adults with AR were exclusively treated by general practitioners. Allergy immunotherapy (AIT) was prescribed for 16.4% of AR patients. Subcutaneous immunotherapy was most frequently used (80% of AIT).
CONCLUSIONS: This study highlights the significant burden of AR. Despite the established benefits of AIT to treat AR and prevent asthma this study suggests significant undertreatment. Future research is necessary to develop and implement adequate measures to increase guideline adherence. This article is protected by copyright. All rights reserved.

PMID: 26749452 [PubMed – as supplied by publisher]

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Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: a population-based cohort.

Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: a population-based cohort.

Thorax. 2012 Feb 14;

Authors: Leynaert B, Sunyer J, Garcia-Esteban R, Svanes C, Jarvis D, Cerveri I, Dratva J, Gislason T, Heinrich J, Janson C, Kuenzli N, de Marco R, Omenaas E, Raherison C, Gómez Real F, Wjst M, Zemp E, Zureik M, Burney PG, Anto JM, Neukirch F

Abstract
BackgroundAlthough women with severe non-allergic asthma may represent a substantial proportion of adults with asthma in clinical practice, gender differences in the incidence of allergic and non-allergic asthma have been little investigated in the general population.MethodsGender differences in asthma prevalence, reported diagnosis and incidence were investigated in 9091 men and women randomly selected from the general population and followed up after 8-10 years as part of the European Community Respiratory Health Survey. The protocol included assessment of bronchial responsiveness, IgE specific to four common allergens and skin tests to nine allergens.ResultsAsthma was 20% more frequent in women than in men over the age of 35 years. Possible under-diagnosis of asthma appeared to be particularly frequent among non-atopic individuals, but was as frequent in women as in men. The follow-up of subjects without asthma at baseline showed a higher incidence of asthma in women than in men (HR 1.94; 95% CI 1.40 to 2.68), which was not explained by differences in smoking, obesity or lung function. More than 60% of women and 30% of men with new-onset asthma were non-atopic. The incidence of non-allergic asthma was higher in women than in men throughout all the reproductive years (HR 3.51; 95% CI 2.21 to 5.58), whereas no gender difference was observed for the incidence of allergic asthma.ConclusionsThis study shows that female sex is an independent risk factor for non-allergic asthma, and stresses the need for more careful assessment of possible non-allergic asthma in clinical practice, in men and women.

PMID: 22334535 [PubMed – as supplied by publisher]

View full post on pubmed: asthma