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Background
Allergic rhinitis is a common condition associated with significant effects on quality of life. Readily available treatments can improve outcomes in rhinitis as well as associated allergic diseases such as asthma. Yet allergic rhinitis remains underdiagnosed and undertreated.
Objective
This article outlines practical strategies and evidence based management of allergic rhinitis.
Discussion
Allergic and nonallelic rhinitis often co-exist. Thorough history of allergen exposure and its relationship to symptoms is vital for the ordering and interpretation of investigations and for management decisions. Some allergen avoidance measures may be ineffective and may cause an unnecessary burden. Demonstrated effective strategies are patient education, intranasal steroids and immunotherapy ('desensitisation'). General practitioners play a vital role in all three strategies, and in supporting patients and families to self manage what is often a chronic condition.
'You know how they did those 12 prick tests... what have you, they have the pollen, the bed mites and things like that. I'm a bit blasé when it comes to things like that... I mean, if [my son] sneezes, he sneezes, you know? What can you do? And that's just part of life. And, unless it gives him chronic, chronic symptoms, I really don't think it's much of a worry. [It] was just general house dust that he was sensitive to unfortunately you have to live with that. You're never going to get away from it. We don't live in a sterile environment.'
Allergy and allergic conditions such rhinitis ('hayfever') arouse a range of community responses from indifference to heightened concern.1 The above quote is from a qualitative study on parental views of their children's allergies2 and typifies attitudes held by many. Interestingly, the parent has also highlighted key issues in recent research; quality of life, undertreatment, allergen avoidance and the importance of patient education.
Allergic rhinitis has tended to be seen as an annoying nuisance rather than a serious disease. However recent studies have documented its impact on quality of life,3-5 with significant effects on sleep, cognitive and psychomotor function, participation in social activities, and learning impairment in children. Economic impact analysis shows the estimated financial cost of allergy in Australia in 2007 was $7.8 billion, with $5.6 billion due to lost productivity.6 While this estimate includes all allergic conditions, allergic...