Author(s):
Bhargab Deka, Bedanta Bhattacharjee, Ashique Ahmed, Arzoo Newar, Bonti Sonowal, Nikita Dey, Dhunusmita Barman, Abu Md Ashif Ikbal, Amlanjyoti Rajkhowa, Alakesh Bharali
Email(s):
abumd97@gmail.com
DOI:
10.5958/2321-5836.2021.00003.3 
Address:
Bhargab Deka1, Bedanta Bhattacharjee1, Ashique Ahmed1, Arzoo Newar1, Bonti Sonowal1, Nikita Dey1, Dhunusmita Barman1, Abu Md Ashif Ikbal2*, Amlanjyoti Rajkhowa2, Alakesh Bharali3
1Department of Pharmaceutical Sciences, Faculty of Science and Engineering, Dibrugarh University, Dibrugarh-786004, Assam, India
2Department of Pharmacy, Tripura University (A Central University), Suryamaninagar-799022, Tripura (W), India
3Department of Pharmacy, Girijananda Chowdhury Institute of Pharmaceutical Sciences- 781017, Guwahati, Assam, India
*Corresponding Author
Published In:
Volume - 13,
Issue - 1,
Year - 2021
ABSTRACT:
Background: Allergic rhinitis (AR) is a major health concern and numerous guidelines have been developed to standardize and to improve the management of this disease. As in many other areas of medicine, the methodology of the AR guidelines has evolved from opinion-based to evidence-based medicine. Although evidence-based medicine has many benefits, it also has limitations and cannot cancel the value of the individual clinical expertise. At present, however, studies on the effectiveness of guidelines are few. The International Consensus on Rhinitis from 1994 is the only guideline for AR that has been assessed for its effects on health outcomes. Furthermore, there is a lack of valid and reliable instruments to assess physicians and patient's attitude towards and compliance with guideline recommendations. There is no single effective way to ensure the use of guidelines into practice, but the most important step of putting guidelines into practice occurs at the level of the patient. Patients should be considered as effective partners in health care. Education of the patient and efforts to change patient's behaviour can maximize compliance, increase satisfaction and optimize health outcomes. Objective: The objective of this study is to provide brief insight about Allergic Rhinitis and various strategies for clinical management of the disease. Methods: Extensive literature survey was carried out and information on various databases viz. PubMed, Google scholar, Scopus and Bibliographic review were retrieved for analysis. Discussion: The discussion and analysis revealed the possible therapeutic management against allergic rhinitis comprising of various non pharmacological and pharmacological methods. Conclusion: Allergic rhinitis can be effectively self-managed on an outpatient basis by incorporating pharmacologic therapy and developing a long-term management plan. Pharmacist, nurse practitioners and physicians can educate patients on importance of attachment to the therapy also help patients with their management of allergic rhinitis will increase patient outcomes and serve a synergistic working relationship among health care providers which will act as a powerful tool that can offer a better health assistance.
Cite this article:
Bhargab Deka, Bedanta Bhattacharjee, Ashique Ahmed, Arzoo Newar, Bonti Sonowal, Nikita Dey, Dhunusmita Barman, Abu Md Ashif Ikbal, Amlanjyoti Rajkhowa, Alakesh Bharali. Clinical Management of Allergic Rhinitis: A Comprehensive Review. Res. J. Pharmacology and Pharmacodynamics.2021; 13(1):9-16. doi: 10.5958/2321-5836.2021.00003.3
Cite(Electronic):
Bhargab Deka, Bedanta Bhattacharjee, Ashique Ahmed, Arzoo Newar, Bonti Sonowal, Nikita Dey, Dhunusmita Barman, Abu Md Ashif Ikbal, Amlanjyoti Rajkhowa, Alakesh Bharali. Clinical Management of Allergic Rhinitis: A Comprehensive Review. Res. J. Pharmacology and Pharmacodynamics.2021; 13(1):9-16. doi: 10.5958/2321-5836.2021.00003.3 Available on: https://rjppd.org/AbstractView.aspx?PID=2021-13-1-3
REFERENCES:
1. Weinick RM, Bristol SJ, DesRoches CM. Urgent care centers in the U.S.: Findings from a national survey. BMC Health Services Research. 2009; 9:79-86. doi: 10.1186/1472-6963-9-79.
2. Urgent Care Association of America. Benchmarking survey headlines summary 2015. Urgent Care Association of America website.//c.ymcdn.com/sites/www.ucaoa.org/resource/resmgr/Infographics/2015_BM_Survey_Headlines_Sum.pdf. Accessed Dec 13, 2020.
3. Allergies and hay fever. CDC website. cdc.gov/nchs/fastats/ allergies.htm. Updated Dec 6, 2020. Accessed Dec 8, 2020.
4. Seidman MD, Gurgel RK, Lin SY, et al. Clinical practice guideline: allergic rhinitis. Otolaryngol Head Neck Surg. 2015;152 (1Suppl):S1-S43. doi: 10.1177/0194599814561600.
5. National ambulatory medical care survey: 2010 summary tables. CDC website. cdc. gov/nchs/data/ahcd/namcs_summary/ 2010_namcs_web_tables.pdf. Accessed Dec 13, 2020.
6. Wallace DV, Dykewicz MS, Bernstein DI, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy ClinImmunol. 2008;122(2 Suppl): S1-S84. doi: 10.1016/ j.jaci.2008.06.003.
7. American College of Allergy, Asthma and Immunology. Allergy facts. ACAAI website. acaai.org/news/facts-statistics/allergies. Accessed June 8, 2016.
8. Bielory L. Allergic conjunctivitis and the impact of allergic rhinitis. Cur Allergy Asthma Rep. 2010;10(2):122-134. doi: 10.1007/s11882-010-0087-1.
9. Hermelingmeier KD, Weber RK, Hellmich M, Heubach CP, Mösges R. Nasal irrigation as an adjunctive treatment in allergic rhinitis: A systematic review and meta-analysis. Am J Rhinol Allergy. 2012;26(5):e119-e125. doi: 10.2500/ajra.2012.26.3787.
10. Zyrtec [package insert]. New York, NY: Pfizer; 2002.
11. Xyzal [package insert]. Smyrna, GA: UCB Inc.; 2008.
12. Allegra [package insert]. Bridgewater, NJ: sanofi-aventis; 2007.
13. Claritin [package insert]. Kenilworth, NJ: Schering Corporation; 2000.
14. Claritin. https://www.claritin.com/. Accessed Dec 20, 2020.
15. Clarinex [package insert]. Whitehouse Station, NJ: Merck & Co.; 2010.
16. Sudafed PE (Phenylephrine) [package insert]. Tarrytown, NY: A&Z Pharmaceuticals, Inc.; 2015.
17. Neo-Synephrine. http://neosynephrine.com. Accessed June 20, 2016.
18. Sudafed PE [package insert]. Hauppauge, NY: A&Z Pharmaceuticals Inc.; 2015.
19. Sudafed [package insert]. Fort Washington, PA: McNeil Consumer Healthcare Division; 2016.
20. Privine [package insert]. Langhorne, PA: Insight Pharmaceuticals Corp.; 2009.
21. Afrin [package insert]. Whitehouse Station, NJ: Merck & Co.; 2013.
22. Singulair [package insert]. Whitehouse Station, NJ: Merck & Co.; 2008.
23. NasalCrom [package insert]. Tarrytown, NY: Prestige Brands Holdings, Inc; 2013.
24. Atrovent Nasal Spray 0.06% [package insert]. Ridgefield, CT: BoehringerIngelheim Pharmaceuticals, Inc.; 2011.
25. Atrovent Nasal Spray 0.03% [package insert]. Ridgefield, CT: BoehringerIngelheim Pharmaceuticals, Inc.; 2002.
26. Bousquet J, van Cauwenberge P, Ait Khaled N, et al. Pharmacology and anti-IgE treatment of allergic rhinitis ARIA update (in collaboration with GA2LEN). Allergy. 2006;61(9):1086-1096.
27. Berger WE, Meltzer EO. Intranasal spray medications for maintenance therapy of allergic rhinitis. Am J Rhinol Allergy. 2015; 29(4):273-282.
28. Berger W, Bousquet J, Fox AT, et al. MP-AzeFlu is more effective than fluticasone propionate for the treatment of allergic rhinitis in children. Allergy. 2016;71(8):1219-1222. doi: 10.1111/all.12903.
29. Scadding, GK, Durham SR, Mirakian R, et al. BSACI guidelines for the management of allergic and non-allergic rhinitis. ClinExp Allergy. 2008;38(1):19-42.
30. Brozek JL, Bousquet J, Baena-Cagnani CE, et al.; Global Allergy and Asthma European Network; Grading of Recommendations Assessment, Development and Evaluation Working Group. Allergic rhinitis and its impact on asthma (ARIA) guidelines: 2010 revision. J Allergy ClinImmunol. 2010;126(3):466–476. doi: 10.1016/j.jaci.2010.06.047.
31. Small P, Kim H. Allergic Rhinitis. Allergy, Asthma ClinImmunol. 2011;7(Suppl 1): S3. doi: 10.1186/1710-1492-7-S1-S3.
32. Nayak A, Langdon RB. Montelukast in the treatment of allergic rhinitis: an evidence based review. Drugs. 2007:67(6):887-901.
33. Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter third update. J Allergy ClinImmunol. 2011;127(1Suppl): S1-S55. doi: 10.1016/j. jaci.2010.09.034.
34. Jacobsen L, Niggemann B, Dreborg S, et al. Specific immunotherapy has longterm preventive effect of seasonal and perennial asthma: 10-year follow-up on the PAT study. Allergy. 2007;62(8):943-948.
35. SLIT Treatment (Allergy Tablets) for allergic rhinitis nothing to sneeze about. AAAAI website. aaaai.org/conditions-and-treatments/library/allergy-library/sublingual-immunotherapy-for-allergic-rhinitis. Accessed Dec 21, 2020.
36. Oralair [package insert]. Antony, 92183, France: Stallergenes SA; 2014.
37. Grastek [package insert]. Whitehouse Station, NJ: Merck & Co.; 2014.
38. Ragwitek [package insert]. Whitehouse Station, NJ: Merck & Co.; 2014.
39. Nelson HS. Subcutaneous immunotherapy versus sublingual immunotherapy: which is more effective? J Allergy ClinImmunol Pract. 2014;2(2):144-149. doi: 10.1016/j.jaip.2013.11.018.
40. Kiel MA, Roder E, Gerth van Wijk R, Al MJ, Hop WC, Rutten-van Mölken MP. Real-life compliance and persistence among users of subcutaneous and sublingual allergen immunotherapy. J Allergy ClinImmunol. 2013;132(2):353-360. doi: 10.1016/ j.jaci.2013.03.013.
41. Smith M, Bates DW, Bodenheimer T, Cleary PD. Why pharmacists belong in the medical home. Health Aff (Millwood). 2010;29(5):906-913. doi: 10.1377/hlthaff.2010.0209.
42. Kuehl, BL, Abdulnour S, O’Dell M, Kyle TK. Understanding the role of the healthcare professional in patients self-management of allergic rhinitis. SAGE Open Med. 2015; 3:2050312115595822. doi:10.1177/2050312115595822.
43. Isasi F, Kroafah E. The expanding role of pharmacists in a transformed healthcare system. Washington, DC: National Governors Association Center for Best Practices, 2015. nga.org/ files/live/sites/NGA/files/pdf/2015/1501TheExpandingRoleOfPharmacists.pdf. Accessed Dec21, 2020.
44. Lourenco O, Calado S, Sá-Sousa A, Fonseca J. Evaluation of allergic rhinitis and asthma control in a Portuguese community pharmacy setting. J Manag Care Spec Pharm. 2014. 20(5):513-522.
45. Simmons-Yon A, Roth MT, Vu M, Kavalieratos D, Weinberger M, Rao JK. Understanding pharmacists’ experiences with advice-giving in the community pharmacy setting: a focus group study. Patient EducCouns. 2012;89(3):476-483. doi: 10.1016/ j.pec.2012.08.011.