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Clinical practice guideline: Allergic rhinitis.

Michael D Seidman1, Richard K Gurgel2, Sandra Y Lin3

  • 1Department of Otolaryngology-Head and Neck Surgery, Henry Ford West Bloomfield Hospital West Bloomfield, Michigan, USA mseidma1@hfhs.org.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
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PubMed
Summary
This summary is machine-generated.

Allergic rhinitis (AR) treatment guidelines recommend intranasal steroids for quality of life and oral antihistamines for sneezing and itching. Diagnosis relies on clinical presentation, with allergy testing for uncertain cases.

Keywords:
acupunctureallergic rhinitisallergic rhinitis and complementary/alternative/integrative medicineallergic rhinitis and steroid use/antihistamine use/decongestant useallergic rhinitis immunotherapyatopic rhinitisatrophic rhinitiscatarrhdiagnosis of allergic rhinitishay feverherbal therapiesmedical management of allergic rhinitisnasal allergiespollinosissurgical management of allergic rhinitis

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Area of Science:

  • Allergy and Immunology
  • Clinical Practice Guidelines
  • Otolaryngology

Background:

  • Allergic rhinitis (AR) is a prevalent chronic condition affecting millions, impacting quality of life and productivity.
  • Significant variation exists in the diagnosis and management of AR, necessitating evidence-based guidance.
  • AR generates substantial direct healthcare expenditures and indirect costs due to lost productivity.

Purpose of the Study:

  • To optimize patient care for allergic rhinitis by addressing quality improvement opportunities.
  • To promote effective diagnosis and therapy while reducing harmful or unnecessary variations in care.
  • To provide evidence-based recommendations for clinicians managing pediatric and adult AR patients (excluding those under 2 years).

Main Methods:

  • Development of a clinical practice guideline based on evaluation of available evidence.
  • Assessment of the harm-benefit balance for various diagnostic and management options for AR.
  • Formulation of strong recommendations, recommendations, and options based on expert consensus and evidence review.

Main Results:

  • Strong recommendation for intranasal steroids for AR impacting quality of life.
  • Strong recommendation for oral second-generation antihistamines for sneezing and itching.
  • Recommendations include clinical diagnosis, selective allergy testing, assessment for comorbidities, and immunotherapy referral.

Conclusions:

  • Clinicians should prioritize intranasal steroids and oral antihistamines based on AR symptoms and impact.
  • Diagnosis should be primarily clinical, supplemented by specific allergy testing when indicated.
  • Comprehensive patient assessment including associated conditions and consideration of immunotherapy are crucial for optimal AR management.