Pharmacist advice to asthmatics regarding antihistamine use

Area of Science:

• Pharmacology and Allergy
• Patient Counseling and Medication Safety

Background:

• Asthma patients frequently experience allergic symptoms, leading them to seek relief with antihistamines.
• Current antihistamine labeling includes warnings for asthma patients, despite limited clinical evidence for contraindication.
• This labeling creates uncertainty regarding appropriate use in individuals with asthma and concurrent allergies.

Purpose of the Study:

• To assess advice given by pharmacists to asthma patients concerning antihistamine use.
• To understand pharmacists' opinions on current antihistamine product labeling for asthmatics.
• To identify potential discrepancies between clinical recommendations and pharmacist practices.

Main Methods:

• A survey was distributed to pharmacists in the Chicago area.
• The survey focused on their advice regarding antihistamine use in asthma patients and their views on product warnings.
• Response rate was 30% of distributed surveys.

Main Results:

• Nearly half (48%) of surveyed pharmacists recommended asthma patients avoid antihistamines.
• Of those recommending avoidance, 75% cited a belief that antihistamines worsen asthma symptoms, lacking strong clinical data.
• Only 17% of pharmacists indicated antihistamines pose no issues for asthma patients; this group showed higher awareness of labeling controversy. Half of all pharmacists surveyed found current labeling inappropriate.

Conclusions:

• A significant proportion of pharmacists provide cautionary advice against antihistamine use for asthma patients based on unsubstantiated concerns.
• Pharmacist recommendations may not align with clinical guidelines, potentially limiting patient access to appropriate allergy treatment.
• Physicians should be aware of this pharmacist behavior, especially until antihistamine labeling is revised to reflect current evidence.