title: Prevalence and impact of rhinitis in asthma. SACRA, a cross-sectional nation-wide study in Japan.
abstract: BACKGROUND
  Asthma and rhinitis are common co-morbidities everywhere in the world but nation-wide studies assessing rhinitis in asthmatics using questionnaires based on guidelines are not available.
  
  
  OBJECTIVE
  To assess the prevalence, classification, and severity of rhinitis using the Allergic Rhinitis and its Impact on Asthma (ARIA) criteria in Japanese patients with diagnosed and treated asthma.
  
  
  METHODS
  The study was performed from March to August 2009. Patients in physicians' waiting rooms, or physicians themselves, filled out questionnaires on rhinitis and asthma based on ARIA and Global Initiative for Asthma (GINA) diagnostic guides. The patients answered questions on the severity of the diseases and a Visual Analog Scale. Their physicians made the diagnosis of rhinitis.
  
  
  RESULTS
  In this study, 1910 physicians enrolled 29,518 asthmatics; 15,051 (51.0%) questionnaires were administered by physician, and 26,680 (90.4%) patients were evaluable. Self- and physician-administered questionnaires gave similar results. Rhinitis was diagnosed in 68.5% of patients with self-administered questionnaires and 66.2% with physician-administered questionnaires. In this study, 994 (7.6%) patients with self-administered and 561 (5.2%) patients with physician-administered questionnaires indicated rhinitis symptoms on the questionnaires without a physician's diagnosis of rhinitis. Most patients with the physician's diagnosis of rhinitis had moderate/severe rhinitis. Asthma control was significantly impaired in patients with a physician's diagnosis of rhinitis for all GINA clinical criteria except exacerbations. There were significantly more patients with uncontrolled asthma as defined by GINA in those with a physician's diagnosis of rhinitis (25.4% and 29.7%) by comparison with those without rhinitis (18.0% and 22.8%).
  
  
  CONCLUSIONS
  Rhinitis is common in asthma and impairs asthma control.
authors.affiliation: Division of Respiratory Medicine and Allergology, Department of Medicine Teikyo University School of Medicine, Tokyo, Japan. kenohta@med.teikyo-u.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Ohta
authors.forename: P-J
authors.initials: PJ
authors.lastname: Bousquet
authors.forename: H
authors.initials: H
authors.lastname: Aizawa
authors.forename: K
authors.initials: K
authors.lastname: Akiyama
authors.forename: M
authors.initials: M
authors.lastname: Adachi
authors.forename: M
authors.initials: M
authors.lastname: Ichinose
authors.forename: M
authors.initials: M
authors.lastname: Ebisawa
authors.forename: G
authors.initials: G
authors.lastname: Tamura
authors.forename: A
authors.initials: A
authors.lastname: Nagai
authors.forename: S
authors.initials: S
authors.lastname: Nishima
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
authors.forename: A
authors.initials: A
authors.lastname: Morikawa
authors.forename: Y
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Kohno
authors.forename: H
authors.initials: H
authors.lastname: Saito
authors.forename: H
authors.initials: H
authors.lastname: Takenaka
authors.forename: L
authors.initials: L
authors.lastname: Grouse
authors.forename: J
authors.initials: J
authors.lastname: Bousquet
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012220:Rhinitis / Q000150:complications* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult