Pharmacist-Led Education Intervention for Adults With Allergic Rhinitis: A Randomized Clinical Trial

Allergic rhinitis (AR) affects 10% to 30% of the adult population globally. The current framework of pharmaceutical care for managing AR focuses on community pharmacies, with limited structured pharmaceutical care in public health care settings.

To evaluate the effectiveness of a pharmacist-led education intervention (AR-PRISE) in a public health care institution compared with standard care for managing AR among adults.

This randomized clinical trial used a 2-arm, parallel-group, open-label design in the otorhinolaryngology clinic of a government-funded tertiary referral hospital in northern Malaysia. Enrollment occurred from June 1, 2023, to February 15, 2024, with follow-up completed August 6, 2024. The trial included Malaysian patients aged 18 to 80 years who had received a diagnosis of AR and were able to comprehend English or Malay. Of the 209 screened patients, 154 were recruited and randomly assigned into intervention and control groups, with 149 completing the study.

The AR-PRISE intervention involved an 8-minute educational video on AR and structured pharmacist counseling.

The primary outcomes were between-group differences at day 180 in knowledge level, symptom control (Total Nasal Symptom Score [TNSS] for the past 12 hours and past 2 weeks), medication adherence (number of days of intranasal corticosteroid use), and quality of life (assessed by the European Quality of Life 5-Dimension 5-Level Instrument and European Quality of Life Visual Analog Scale). Assessments were conducted at baseline and days 60 (±7), 120 (±7), and 180 (±7). All analyses were performed on an intention-to-treat basis.

Among the 154 participants, the mean (SD) age was 46.5 (17.0) years, and 97 (63.0%) were women; 77 participants were randomized to each group. In the intention-to-treat analysis, the intervention group showed statistically significant improvement in TNSSs for the past 2 weeks compared with controls (estimate [SE], 0.14 [0.06]; 95% credible interval [CrI], 0.03-0.25). Significant reductions in the TNSS for the past 2 weeks were observed at all time points (day 60: estimate [SE], 0.18 [0.05]; 95% CrI, 0.08-0.28; day 120: estimate [SE], 0.21 [0.05]; 95% CrI, 0.11-0.31; and day 180: estimate [SE], 0.11 [0.05]; 95% CrI, 0.01-0.21). No significant differences were observed for knowledge level, TNSS for the past 12 hours, medication adherence, or quality of life.

In this randomized clinical trial, the AR-PRISE intervention significantly improved AR symptom control (TNSS for the past 2 weeks) compared with standard care over 180 days but did not show significant effects on other coprimary outcomes (AR knowledge, TNSS for the past 12 hours, medication adherence, or quality of life). These findings suggest that while pharmacist-led education can enhance symptom management, additional strategies may be needed to address broader aspects of AR care.

ClinicalTrials.gov Identifier: NCT06027736.