[Evaluation of quality of life (QOL) and efficacy of drug therapy on nasal symptoms and QOL disturbances in the patients with Japanese Cedar Pollinosis during the season of 2003 in Kyushu and Okinawa districts].
OBJECTIVE
The aim of the study is to investigate nasal symptom severity (NSS) and disturbance of quality of life (QOLD) of patients with Japanese Cedar Pollinosis (JCP) during the JC season of 2003, and to evaluate the efficacy of drug treatment on the NSS/QOLD by the data based on disease specific Japan Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ).


RESULTS
3173 patients with JCP from 149 clinics of 8 prefectures in Kyushu and Okinawa districts were subjected. Degree of NSS/QOLD was scored as 1 to 4 in order (1 for a little and 4 for extremely severe or bothered respectively). (1) About 23% of 3173 subjects analyzed complained NSS score > or =3 and about 64% score > or =2. About 10% complained QOLD score > or =3 and about 20-30% score > or =2. (2) Preventive effect of pre-seasonal medication was analyzed. We evaluated the data from 583 patients (177 : received pre-seasonal medication and 406 : not received) who first answered questionnaire before peak of pollen dispersion as the effects on rising-up of symptoms in early stage of pollen scattering, and the data from 1223 patients (431 : received pre-seasonal medication and 792 : not received) who answered during the whole season as the effects on symptoms in whole season. The results of the both analyses indicated that the pre-seasonal medication significantly reduced NSS/QOLD in early stage of pollen scattering as well as during whole season as a preventive effect. (3) Effect of drugs prescribed at the first reply to the questionnaire was analyzed in 582 patients who answered the questionnaire twice before and after the peak of JC pollen scattering (February 28th), with at least 7 days intervals between 2 answers. When a proper designate of prescribed drug was not specified, results of second answer from 582 patients showed significant reduction of NSS/ QOLD score (p<0.001). (4) Single drug which effect was able to be evaluated was anti-allergic drug (mainly second generation of anti histamine: aH) in 81 cases, or anti-leukotriene (aLT) in 25 cases. Although the both drugs were effective, the comparison analysis of effectiveness of 2 drugs indicated that effect of aLT on reduction of NSS/QOLD score was higher than that of aH. Effect of combination drug treatment was able to be evaluated in aH + topical steroids (tS) in 95 cases, aLT + tS in 12 cases and aH + aLT in 25 cases. Those 3 ways of combination were effective, especially the combination with topical steroids with either aH or aLT showed significant higher effect on reduction of NSS/QOLD.


CONCLUSIONS
JRQLQ is useful questionnaire for general clinic to evaluate the QOL disturbances induced by JCP and to follow clinical process relating to QOL changes including effect of drug treatment.
Ishikawa
Takeru
T
Professor Emeritus of Kumamoto University School of Medicine.
Soh
Nobuo
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D002648:Child; D032485:Cryptomeria; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000276:immunology; D011058:Pollen / Q000276:immunology*; D015995:Prevalence; D011788:Quality of Life; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D012621:Seasons
D018926:Anti-Allergic Agents