Treatment trends in allergic rhinitis and asthma: a British ENT survey

A questionnaire was emailed to all registered consultant members of the British Association of Otorhinolaryngologists - Head and Neck Surgeons regarding the management of patients with Allergic Rhinitis and related disorders.Survey response rate was 56%. The results indicate a various approach in the investigation and management of Allergic Rhinitis compatible with recommendations from the Allergic Rhinitis and Its Impact on Asthma guidelines in collaboration with the World Health Organisation.A combined management approach for patients with Allergic Rhinitis and concomitant Asthma may reduce medical treatment costs for these conditions and improve symptom control and quality of life.The definition of Allergic Rhinitis (AR) was formulated by Hansel in 1929 [1]. It is a symptomatic nasal disorder caused by allergen exposure through an IgE-mediated immune response against allergens. AR can be subdivided into intermittent (symptoms <4 days per week or for <4 weeks) and persistent disease (symptoms >4 days per week or for >4 weeks) and is further characterized according to severity as mild or moderate/severe [2].The nasal passage and paranasal sinuses are an integral part of the respiratory tract and patients may have rhinitis without sinusitis, but not sinusitis without rhinitis, hence the term rhinitis has been replaced in modern ENT literature by the more accurate term rhinosinusitis [3]. AR and Asthma are linked epidemiologically, pathologically, physiologically and therapeutically and can be considered as a manifestation of a single inflammatory airway syndrome [4]. Most patients with Asthma have rhinitis suggesting the concept of "one airway, one disease" [5]. AR is more prevalent than Asthma and a European population study was reported to have an AR prevalence rate of 25% [6]. AR usually precedes Asthma and can be considered as risk factor for the development of Asthma. Rhinitis exists in up to 80% of Asthma patients and frequently exacerbates Asthma and increase