Allergic rhinitis: can we identify nonadherence to therapy and its predictors easily in daily practice?

Allergic rhinitis (AR) is a common chronic condition with significant consequences if left untreated (e.g., poor health outcomes, disease progression, and increased health care costs). However, about half of all patients do not fill their prescription.The factors associated with adherence are complex, and many remain poorly defined and understood.

This pilot study had 2 objectives. First, to determine whether the medication adherence report scale (MARS) can be applied to identify adherence/nonadherence in patients with AR using patients with chronic obstructive pulmonary disease (COPD) as controls. Second, to identify AR profiles that indicate a particularly high risk of nonadherence.

AR patients completed the Eysenck Personality Questionnaire-Revised Abbreviated-Form (EPQR-A), the Short Form 36 Health Survey (SF-36), the Mini Rhinitis Quality of Life Questionnaire (Mini-RQLQ), and the MARS. Symptom severity was assessed before and after treatment.

The study population comprised 85 AR patients and 50 COPD patients. Females had worse adherence (significant only in total and unintentional scores) and higher extraversion scores. None of the personality traits predicted adherence. Neuroticism was negatively correlated with the SF-36 score (P < .001). A low to moderate correlation was observed between posttreatment improvement in specific/ generic health-related quality of life and MARS scores in AR patients (P = .002, r = 0.332; and P = .022, r = -0.251; respectively). Higher educational level was found to significantly increase adherence (P = .01, r = 0.223).

Our study did not reveal a personality effect. However, it did suggest that use of a brief, self-completed medication adherence questionnaire in daily practice can enable health professionals to identify suboptimal adherence in patients who would benefit from close follow-up.