title: Treatment of chronic rhinitis by an allergy specialist improves quality of life outcomes.
abstract: BACKGROUND
  Allergic rhinitis is associated with significant impairment in quality of life and therefore has a significant impact on the indirect health care costs associated with treatment of chronic rhinitis in the United States. It has been stated that early intervention in the treatment of chronic rhinitis by an allergy specialist improves health outcomes but few unbiased studies have been conducted to substantiate this claim.
  
  
  OBJECTIVE
  This study measured quality of life outcomes in the treatment of chronic rhinitis by an allergy specialist.
  
  
  METHODS
  Quality of life changes were assessed using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and the "Short-Form" 36-item questionnaire (SF-36) in patients before and after treatment of chronic rhinitis symptoms by a board-certified allergist. Patients with chronic rhinitis were asked by a 3rd year medical student to complete these questionnaires prior to any contact with the allergist. Treatment by the allergist included counseling on avoidance measures when appropriate and a new medication regimen. Patients were contacted by the 3rd year medical student 3 to 5 months later to complete follow-up RQLQ and SF-36 surveys. All data analysis was conducted independently by the 3rd year medical student.
  
  
  RESULTS
  Complete sets of pre-treatment and post-treatment surveys were obtained from 19 patients. Perennial allergic rhinitis was diagnosed for 13 patients, perennial allergic rhinitis with a seasonal component was diagnosed for three patients, vasomotor rhinitis was diagnosed for two patients and mixed allergic and non-allergic rhinitis was diagnosed for one patient. Statistically significant improvement was observed in four of the nine health concepts measured by the SF-36 questionnaire. Significant changes above the minimal important difference (MID) were observed post-treatment in six of eight RQLQ dimensions.
  
  
  CONCLUSIONS
  This study indicates that intervention by a board-certified allergist significantly improves many areas of health-related quality of life. Further studies comparing health care outcomes and costs of treating chronic rhinitis by primary care physicians to early intervention by allergy specialists are warranted.
authors.affiliation: University of Cincinnati College of Medicine, Ohio 45267-0563, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Bagenstose
authors.forename: J A
authors.initials: JA
authors.lastname: Bernstein
mesh_terms: D000328:Adult; D000486:Allergy and Immunology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D012220:Rhinitis / Q000628:therapy*; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000628:therapy; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000628:therapy; D012223:Rhinitis, Vasomotor / Q000175:diagnosis / Q000628:therapy; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome