As-Needed Versus Regular Medication Use in the Treatment of Allergic Rhinitis in the Pollen Season: A MASK-air Study

Patients with allergic rhinitis often use as-needed medication instead of regular treatment. Using data from the MASK-air mHealth app, we compared weeks with use of as-needed versus regular medication on treatment satisfaction and symptom control.

We assessed data from the MASK-air app. We compared weeks in the pollen season in which patients reported the use of one same medication during all the days in the week ("regular treatment") versus those in which patients reported the use of the same single medication (and no other treatments) in at most 4 days per week ("as-needed treatment"). We built mixed-effects linear regression models, evaluating the differences between regular and as-needed treatments on visual analogue scales for symptom control and treatment satisfaction. We performed sensitivity analyses (i) considering a different definition of as-needed treatment (use of medication ≤ 2 days per week), and (ii) evaluating treatment days preceded by non-treatment days.

We assessed 2690 weeks (18,830 days, 1042 MASK-air users). For intranasal corticosteroids (INCS) and fixed combinations of intranasal antihistamines (INAH) + INCS, there were no significant differences between as-needed versus regular treatments for treatment satisfaction. For oral antihistamines (OAH) and INCS + OAH, results tended to favour as-needed approaches. For symptom control, we observed either no significant differences between the two approaches or significant differences favouring as-needed medication use. Similar results were found in the sensitivity analyses.

Some patients use medication regularly and others use it on-demand. This study shows that both approaches can satisfy patients and result in good disease control.