150 International Survey on the Management of Allergic Rhinitis by Physicians and Patients (ISMAR). Physicians' View

BACKGROUND: Allergic Rhinitis (AR) is a worldwide spread disease and has an important impact on social life, sleep quality (SQ), school and work productivity and huge direct costs. ISMAR was designed to identify attitudes and medical trends among physicians managing AR in different parts of the world. This study presents the physicians´ view and attitudes. METHODS: ISMAR is an international, multicenter, non-interventional and cross-sectional study conducted in adults and children (≥6 years) with physicians-diagnosed AR from 11 countries (Egypt, Mexico, Brazil, Colombia, Guatemala, Iran, Venezuela, Argentina, Israel, Kuwait, United Arab Emirates). Doctors from 4 specialties were required in each country: (i) GPs/Family doctors/internists, (ii) pediatricians, (iii) allergologists/pulmonologists, and (iv) ENT. They were invited to participate in the study from master lists of physicians attending patients with AR in their respective countries and answered the Doctor Questionnaire that included questions about guidelines awareness, relevant AR symptoms, and preference for prescribing medication, among others. RESULTS: Two hundred and thirty four physicians participated in the study. Most of them were awared about ARIA (82.5%), GINA (71.4%). They followed guidelines recommandations to classify patients severity (84.2%) and for choosing the treatment accordingly (84.6%). Key symptoms to make AR diagnosis were: congestion (84.8%), sneezing (79.1%), anterior watery rhinorrhea (75.9%). SQ and AR severity were assessed mainly by clinical history (97.1% and 98%). The main reasons to prescribe medication were: symptom severity/frequency (97.9%), drug efficacy (85.9%) and safety (76.5%). Other less relevant raisons were: personal experience (65%), cost (55.1%) and frequency of dosages (54.7%). The preferred medications were oral antihistamines (OH1A) and intranasal corticosteroids (INC) [5 in a 0–5 scale]. Other treatments (oral decongestants, leukotriene antagonists, SCIT/SLIT), among others were considered as second level in preference. CONCLUSIONS: Guidelines are well known and useful to physicians. Clinical history was the main way to evaluate the patient's sleep quality, classification, severity and election of treatment. Objective measures for assessment were scarcely used. OH1A and INC were the most widely recommended treatment for AR and were considered effective and safe.