title: The status quo and unmet needs in the management of allergic rhinitis and chronic rhinosinusitis: a Malaysian perspective.
abstract: BACKGROUND
  Allergic rhinitis and rhinosinusitis, common and debilitating conditions, should be managed in accordance with guideline recommendations. Guideline adherence shows regional differences. As of now, there is little data from Asia and none from Malaysia on the current treatment practices and unmet needs in the management of these conditions.
  
  
  OBJECTIVE
  The objective of this study was to assess the current practice in the management of allergic rhinitis and rhinosinusitis by conducting a survey among ear, nose and throat (ENT) specialists, pharmacists, and general practitioners (GPs) in Malaysia.
  
  
  METHODS
  We conducted a survey study among ENT specialists, pharmacists, and GPs in Malaysia, who answered a multiple choice questionnaire focused on the current practice in the management of allergic rhinitis and rhinosinusitis in their respective field. More than 200 ENT specialists, 100 pharmacists, and 200 GPs participated in the survey.
  
  
  RESULTS
  Antihistamines were the most preferred choice for the treatment of mild allergic rhinitis by ENT specialists (45%), pharmacists (78%), and GPs (51%), with the most preferable duration of <2 weeks. In moderate-to-severe allergic rhinitis, a combination of antihistamines and intranasal steroids was the most preferred treatment of choice in 90% of ENT specialists, 72% of pharmacists, and 69% of GPs. Efficacy of antihistamines was the main criteria of choice in 58%, 53%, and 38% of ENT specialists, pharmacists, and GPs, respectively. Notably, complaints of drowsiness associated with nonsedative antihistamines were the major unmet need identified in the survey. For chronic rhinosinusitis, a combination of antihistamines and intranasal steroids was the most preferred treatment. The majority of the respondents preferred a treatment duration of >3 months with antihistamines. Satisfaction with the recommendations in the current Allergic Rhinitis and its Impact on Asthma (ARIA) guideline was high; 66%, 58%, and 89% of the ENT specialists, pharmacists, GPs, respectively, reported that the current ARIA guidelines are sufficient for their clinical/pharmacy practice.
  
  
  CONCLUSIONS
  The current practices in the management of allergic rhinitis in Malaysia are largely in line with the ARIA guidelines. The majority of physicians and pharmacists are satisfied with the recommendations in the ARIA guidelines.
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery, University Malaya Faculty of Medicine, Kuala Lumpur 50603, Malaysia.
authors.forename: Narayanan
authors.initials: N
authors.lastname: Prepageran
authors.affiliation: Department of Otolaryngology, National University of Singapore, Singapore 119077, Singapore.
authors.forename: De Yun
authors.initials: de Y
authors.lastname: Wang
authors.affiliation: Lam Wah Ee Hospital, Pulau Pinang 11600, Malaysia.
authors.forename: Gopalan
authors.initials: G
authors.lastname: Nair
authors.affiliation: Department of Dermatology and Allergy, Allergie-Centrum-Charité of the Charité-Universitätsmedizin Berlin, Berlin 10117, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Maurer
keywords: Allergic rhinitis; General practitioners; Histamine antagonists; Pharmacists; Professional practice
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