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Physicians’ prescribing behaviour and clinical practice patterns for allergic rhinitis management in Italy

BACKGROUND: Despite availability of clinical guidelines, underdiagnosis, undertreatment, and poor adherence are still significant concerns in allergic rhinitis (AR) therapeutic management. We investigated clinical practice patterns and prescribing behavior of Italian healthcare professionals (HCPs)...

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Autores principales: Passalacqua, Giovanni, Musarra, Antonino, Senna, Gianenrico, Bousquet, Jean, Ferrara, Carmen, Lonati, Caterina, Canonica, Giorgio Walter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640419/
https://www.ncbi.nlm.nih.gov/pubmed/33292294
http://dx.doi.org/10.1186/s12948-020-00135-4
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author Passalacqua, Giovanni
Musarra, Antonino
Senna, Gianenrico
Bousquet, Jean
Ferrara, Carmen
Lonati, Caterina
Canonica, Giorgio Walter
author_facet Passalacqua, Giovanni
Musarra, Antonino
Senna, Gianenrico
Bousquet, Jean
Ferrara, Carmen
Lonati, Caterina
Canonica, Giorgio Walter
author_sort Passalacqua, Giovanni
collection PubMed
description BACKGROUND: Despite availability of clinical guidelines, underdiagnosis, undertreatment, and poor adherence are still significant concerns in allergic rhinitis (AR) therapeutic management. We investigated clinical practice patterns and prescribing behavior of Italian healthcare professionals (HCPs) specialized in AR. METHODS: One-hundred allergologists, 100 ear, nose and throat (ENT) specialists, and 150 general practitioners (GPs) were recruited. The survey assessed: socio-demographic, work experience, monthly caseload, prescription drivers. Next, HCPs were invited to retrospectively recover patients’ clinical data to investigate: AR clinical characteristics, therapy management, prescription patterns, patient adherence. Descriptive statistics, Chi square, One-Way analysis of variance, and Two-Way Analysis of Variance were performed. RESULTS: Allergologists visited more AR patients (31% of monthly caseload) than ENTs (21%, p < 0.001), while GPs’ caseload was the lowest (6%). Clinical information of 2823 patients were retrieved of whom 1906 (67.5%) suffered from moderate/severe AR (discomfort score: 7.7 ± 1.3) and 917 (32.4%) from mild AR (5.7 ± 1.9). About one-third of mild patients had a discomfort score ≥ 7. Main prescription drivers were “effective on all symptoms” (54.3% patients) and “quick symptom relief” (47.8%), whereas minor drivers were “affordable price” (13.4%) and “refundable” (8.7%). The most prescribed drugs were antihistamines and intranasal corticosteroids (79% and 55% prescriptions), followed by fixed-dose-combination of intranasal azelastine/fluticasone (19%). Polytherapy was the most common treatment strategy (59.6%). HCPs’ believe that the majority of the patients was adherent to treatment (88% with score > 7). CONCLUSIONS: This survey describes the therapeutic approach adopted by Italian physicians to cope with AR and shows that HCPs underestimated AR severity and had a non-realistic perception of patients’ adherence. These findings suggest that further efforts are required to improve AR clinical management in Italy.
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spelling pubmed-76404192020-11-04 Physicians’ prescribing behaviour and clinical practice patterns for allergic rhinitis management in Italy Passalacqua, Giovanni Musarra, Antonino Senna, Gianenrico Bousquet, Jean Ferrara, Carmen Lonati, Caterina Canonica, Giorgio Walter Clin Mol Allergy Research BACKGROUND: Despite availability of clinical guidelines, underdiagnosis, undertreatment, and poor adherence are still significant concerns in allergic rhinitis (AR) therapeutic management. We investigated clinical practice patterns and prescribing behavior of Italian healthcare professionals (HCPs) specialized in AR. METHODS: One-hundred allergologists, 100 ear, nose and throat (ENT) specialists, and 150 general practitioners (GPs) were recruited. The survey assessed: socio-demographic, work experience, monthly caseload, prescription drivers. Next, HCPs were invited to retrospectively recover patients’ clinical data to investigate: AR clinical characteristics, therapy management, prescription patterns, patient adherence. Descriptive statistics, Chi square, One-Way analysis of variance, and Two-Way Analysis of Variance were performed. RESULTS: Allergologists visited more AR patients (31% of monthly caseload) than ENTs (21%, p < 0.001), while GPs’ caseload was the lowest (6%). Clinical information of 2823 patients were retrieved of whom 1906 (67.5%) suffered from moderate/severe AR (discomfort score: 7.7 ± 1.3) and 917 (32.4%) from mild AR (5.7 ± 1.9). About one-third of mild patients had a discomfort score ≥ 7. Main prescription drivers were “effective on all symptoms” (54.3% patients) and “quick symptom relief” (47.8%), whereas minor drivers were “affordable price” (13.4%) and “refundable” (8.7%). The most prescribed drugs were antihistamines and intranasal corticosteroids (79% and 55% prescriptions), followed by fixed-dose-combination of intranasal azelastine/fluticasone (19%). Polytherapy was the most common treatment strategy (59.6%). HCPs’ believe that the majority of the patients was adherent to treatment (88% with score > 7). CONCLUSIONS: This survey describes the therapeutic approach adopted by Italian physicians to cope with AR and shows that HCPs underestimated AR severity and had a non-realistic perception of patients’ adherence. These findings suggest that further efforts are required to improve AR clinical management in Italy. BioMed Central 2020-11-03 /pmc/articles/PMC7640419/ /pubmed/33292294 http://dx.doi.org/10.1186/s12948-020-00135-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Passalacqua, Giovanni
Musarra, Antonino
Senna, Gianenrico
Bousquet, Jean
Ferrara, Carmen
Lonati, Caterina
Canonica, Giorgio Walter
Physicians’ prescribing behaviour and clinical practice patterns for allergic rhinitis management in Italy
title Physicians’ prescribing behaviour and clinical practice patterns for allergic rhinitis management in Italy
title_full Physicians’ prescribing behaviour and clinical practice patterns for allergic rhinitis management in Italy
title_fullStr Physicians’ prescribing behaviour and clinical practice patterns for allergic rhinitis management in Italy
title_full_unstemmed Physicians’ prescribing behaviour and clinical practice patterns for allergic rhinitis management in Italy
title_short Physicians’ prescribing behaviour and clinical practice patterns for allergic rhinitis management in Italy
title_sort physicians’ prescribing behaviour and clinical practice patterns for allergic rhinitis management in italy
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640419/
https://www.ncbi.nlm.nih.gov/pubmed/33292294
http://dx.doi.org/10.1186/s12948-020-00135-4
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