title: 'Help for Hay Fever', a goal-focused intervention for people with intermittent allergic rhinitis, delivered in Scottish community pharmacies: study protocol for a pilot cluster randomized controlled trial.
abstract: BACKGROUND
  Despite the availability of evidence-based guidelines for managing allergic rhinitis in primary care, management of the condition in the United Kingdom (UK) remains sub-optimal. Its high prevalence and negative effects on quality of life, school performance, productivity and co-morbid respiratory conditions (in particular, asthma), and high health and societal costs, make this a priority for developing novel models of care. Recent Australian research demonstrated the potential of a community pharmacy-based 'goal-focused' intervention to help people with intermittent allergic rhinitis to self-manage their condition better, reduce symptom severity and improve quality of life. In this pilot study we will assess the transferability of the goal-focused intervention to a UK context, the suitability of the intervention materials, procedures and outcome measures and collect data to inform a future definitive UK randomized controlled trial (RCT).
  
  
  METHODS
  A pilot cluster RCT with associated preliminary economic analysis and embedded qualitative evaluation. The pilot trial will take place in two Scottish Health Board areas: Grampian and Greater Glasgow & Clyde. Twelve community pharmacies will be randomly assigned to intervention or usual care group. Each will recruit 12 customers seeking advice or treatment for intermittent allergic rhinitis. Pharmacy staff in intervention pharmacies will support recruited customers in developing strategies for setting and achieving goals that aim to avoid/minimize triggers for, and eliminate/minimize symptoms of allergic rhinitis. Customers recruited in non-intervention pharmacies will receive usual care. The co-primary outcome measures, selected to inform a sample size calculation for a future RCT, are: community pharmacy and customer recruitment and completion rates; and effect size of change in the validated mini-Rhinoconjunctivitis Quality of Life Questionnaire between baseline, one-week and six-weeks post-intervention. Secondary outcome measures relate to changes in symptom severity, productivity, medication adherence and self-efficacy. Quantitative data about accrual, retention and economic measures, and qualitative data about participants' experiences during the trial will be collected to inform the future RCT.
  
  
  CONCLUSIONS
  This work will lay the foundations for a definitive RCT of a community pharmacy-based 'goal-focused' self-management intervention for people with intermittent allergic rhinitis. Results of the pilot trial are expected to be available in April 2013.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN43606442.
authors.affiliation: Division of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK.
authors.forename: Terry
authors.initials: T
authors.lastname: Porteous
authors.forename: Sally
authors.initials: S
authors.lastname: Wyke
authors.forename: Sarah
authors.initials: S
authors.lastname: Smith
authors.forename: Christine
authors.initials: C
authors.lastname: Bond
authors.forename: Jill
authors.initials: J
authors.lastname: Francis
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Lee
authors.forename: Richard
authors.initials: R
authors.lastname: Lowrie
authors.forename: Graham
authors.initials: G
authors.lastname: Scotland
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh
authors.forename: Mike
authors.initials: M
authors.lastname: Thomas
authors.forename: Lorraine
authors.initials: L
authors.lastname: Smith
mesh_terms: D018926:Anti-Allergic Agents / Q000191:economics / Q000627:therapeutic use*; D003157:Community Pharmacy Services / Q000191:economics; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D016527:Drug Costs; D006801:Humans; D055118:Medication Adherence; D010865:Pilot Projects; D036301:Qualitative Research; D011788:Quality of Life; D012107:Research Design; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D012606:Scotland; D012648:Self Care; D020377:Self Efficacy; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents