National survey on the management of rhinopathies in asthma patients by French pulmonologists in everyday practice.
BACKGROUND
Epidemiological and pathophysiologic studies have shown that allergic rhinitis and asthma often occur in combination. The internationally developed ARIA position paper (Allergic Rhinitis and its Impact on Asthma) recently offered recommendations on allergic rhinitis. As part of this new report and prior to its diffusion, we investigated the management of rhinopathies in asthma patients by pulmonologists in their everyday practice.


METHODS
From March to June 2000, 477 (48%) French pulmonologists in office-based practice participated in the survey. They were asked to include their first five asthmatic adult patients. In addition to descriptive statistics, univariate and multivariate analyzes were performed.


RESULTS
We studied 1623 patients with varying severity of asthma (sex ratio 0.9; median age 35 years). The pulmonologists reported rhinopathy in 76.6% of these, with a chronic course in 91%. Among the patients, 67.1% reported rhinopathy. The diagnosis was allergic rhinitis in 66.2% of participants and nasal polyposis in 10.1%. Examination of the nasal cavities was performed by the pulmonologists themselves in 56.2% of patients. Imaging of the sinuses was performed radiographically in 55.3% of enrolled patients and/or by computed tomography in 17.2%. Referral to an ENT specialist occurred for 21.6% of patients, being more common for patients with rhinitis that failed to respond to medical therapy (although some pulmonologists referred their patients routinely).


CONCLUSIONS
The high prevalence of rhinopathies in asthma patients requires that these conditions are recognized and managed by pulmonologists. Thus, our findings support one of the central messages contained in the new ARIA guidelines-asthma patients should be investigated routinely for rhinitis and other rhinopathies.
Demoly
P
P
Maladies Respiratoires, INSERM U454-IFR3, Hôpital Arnaud de Villeneuve, University of Montpellier, France.
Crampette
L
L
Daures
J-P
JP
D000328:Adult; D001249:Asthma / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D010036:Otolaryngology; D011364:Professional Practice / Q000706:statistics & numerical data; D015272:Pulmonary Medicine / Q000706:statistics & numerical data*; D011788:Quality of Life; D012017:Referral and Consultation; D012220:Rhinitis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*