Epidemiological survey in hay fever patients: symptom prevalence and severity and influence on patient management

The prevalence and severity of symptoms of self-reported hay fever were assessed in 509 symptomatic patients not currently receiving treatment who consulted their physicians in Switzerland during the 1994 pollen season. Conjunctivitis was diagnosed in 93.3% of cases (in 8% isolated), rhinitis in 92% (isolated in 6.7%). 24.2% suffered from current asthma symptoms. The severity of the asthma symptoms was mild in 43.9%, moderate in 48% and severe in 8.1%. When the main symptomatology of hay fever (excluding asthma) was taken into account (the diagnosis with the severest symptomatology), 22.4% of patients suffered predominantly from conjunctivitis, 24.6% from rhinitis and 53% from both. Onset of symptoms typically occurred between March and May and lasted on average 2.7 +/- 1.8 months. Severe symptoms were most common in the rhinitis group and least common in the rhinoconjunctivitis group. Conjunctivitis was more common than rhinitis in younger patients, whilst asthma prevalence increased with age (so-called "Etagenwechsel"). Topical therapy was the preferred treatment for all three symptomatologies and particularly for conjunctivitis. Overall, topical therapy was recommended for 50.5% of patients and in a further 33% in combination with oral therapy. In conclusion, conjunctivitis symptoms are at least as severe as rhinitis symptoms in approximately 70% of patients with hay fever. This would appear to influence clinical management as indicated by a preference for topical therapy.