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Are you comfortable with over-the-counter intranasal steroids for children? A call to action
Gary Rachelefsky1, Judith Rosen Farrar2
1Center for Asthma, Allergy, and Respiratory Diseases, Geffen School of Medicine at University of California Los Angeles, Los Angeles, Calif.
Insights
Early allergic rhinitis in children can signal lifelong issues. Over-the-counter treatments risk delayed diagnosis, highlighting the need for expert medical guidance in pediatric allergy management.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Healthcare Delivery
Background:
- Early allergic rhinitis in children is linked to long-term health problems and comorbidities.
- Pediatric allergic rhinitis management in the U.S. is shifting towards unsupervised self-care.
- Concerns exist regarding over-the-counter (OTC) intranasal steroids for young children and a retail healthcare model.
Purpose of the Study:
- To address the challenges in diagnosing and managing pediatric allergic rhinitis.
- To emphasize the importance of appropriate diagnosis and treatment for children.
- To call for action from allergists and medical organizations to improve pediatric allergy care.
Main Methods:
- Review of current trends in pediatric allergic rhinitis treatment.
- Analysis of the impact of OTC medications and retail healthcare models.
- Discussion of diagnostic and management strategies for children.
Main Results:
- Current trends may lead to delayed diagnosis of allergic rhinitis in children.
- OTC treatments for nasal symptoms alone can mask underlying issues.
- Ensuring appropriate diagnosis and management remains a significant challenge.
Conclusions:
- Allergic rhinitis in children requires careful diagnosis and management beyond symptom relief.
- Allergists and medical organizations must lead efforts to improve pediatric allergy care.
- Increased awareness and structured approaches are crucial for effective treatment.
Abstract:
The early expression of allergic rhinitis in children is a potential red flag for lifelong problems and comorbid conditions. However, treating pediatric allergic rhinitis in the United States is trending toward a self-management or parental management model with little clinical supervision, which reflects changes in the delivery of health care. Of particular concern are the recent approval of an over-the-counter intranasal steroid to treat nasal allergy symptoms in adults and children as young as age 2 years and the push for a retail model of health care as exists in some other countries. For children with allergic rhinitis, treating nasal symptoms alone with over-the-counter products may further delay a diagnosis that is often already ignored due to its "annoyance factor" as opposed to being considered a serious health issue. How to ensure an appropriate diagnosis and management for these children remains a challenge, regardless of who is doing the treating. The call to action is for allergists and allergy medical organizations to drive the effort to ensure awareness of the why and how for appropriately diagnosing and treating allergic rhinitis in children. Starting points for the discussion are provided.
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