The Burden of Self-Reported Rhinitis and Associated Risk for Exacerbations with Moderate-Severe Asthma in Primary...

Area of Science:

• Respiratory Medicine
• Allergy and Immunology
• Clinical Epidemiology

Background:

• Rhinitis is a common comorbidity in asthma patients, yet its prevalence, severity, and impact on asthma exacerbations remain under-researched.
• Optimal management of asthma, particularly at Global Initiative for Asthma (GINA) Step 3 and above, may be hindered by undiagnosed or undertreated rhinitis.

Purpose of the Study:

• To determine the prevalence, severity, and treatment of self-reported rhinitis in adults with asthma (GINA Step 3+).
• To compare characteristics between asthma patients with and without rhinitis.
• To assess the association between patient-reported rhinitis and the risk of asthma exacerbations.

Main Methods:

• Cross-sectional observational study using data from the iHARP asthma review service (2011-2014).
• Inclusion of 4274 adult asthma patients (GINA Step 3+).
• Data collected via practitioner and patient questionnaires on demographics, rhinitis/asthma symptoms, exacerbations, and medication use; statistical analysis included logistic regression.

Main Results:

• 67.4% of asthma patients reported rhinitis symptoms, with 65.7% undiagnosed by a doctor.
• Moderate-to-severe rhinitis was linked to a 40% increased risk of asthma exacerbations (OR=1.40).
• Patients with moderate-to-severe rhinitis were more likely to have GINA-uncontrolled asthma compared to those with mild or no rhinitis.

Conclusions:

• A significant gap exists in the diagnosis and management of rhinitis among adults with asthma (GINA Step 3+).
• Healthcare practitioners should actively identify, evaluate, and treat rhinitis in asthma patients.
• Optimal rhinitis management is crucial for reducing asthma exacerbation risk in this population.