title: Practical clinical approaches to the allergic rhinitis patient.
abstract: BACKGROUND
  Numerous treatment strategies are available for the treatment of allergic rhinitis (AR), including environmental controls, pharmacotherapy, immunotherapy, and surgery in appropriately selected patients. A stepwise algorithmic approach based on disease severity and persistence of symptoms is often advocated to effectively manage patients with AR.
  
  
  METHODS
  A review is provided of current evidence and guidelines for the management of AR. Practical clinical strategies to improve patient adherence to therapy and outcome are described.
  
  
  RESULTS
  Algorithms to manage AR are based on the severity and persistence of disease. A tailored strategy geared toward addressing symptoms that are most troublesome to the patient is beneficial, as is the assessment of comorbid conditions such as rhinosinusitis, asthma, and laryngopharyngeal reflux. Allergen-specific immunotherapy (AIT) is an underused treatment modality and patients with persistent AR should be considered candidates for desensitization, if appropriate. Assessment of patient outcome is important and the use of validated symptom surveys can provide an objective measure of quality of life.
  
  
  CONCLUSIONS
  A large armamentarium of treatment options is available to the otolaryngologist treating the patient with AR. A step-wise and tailored approach with equal attention dedicated to patient education and assessment of patient outcome can be helpful to improve efficacy of treatment.
authors.affiliation: Division of Sinonasal Disorders and Allergy, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Stella
authors.initials: S
authors.lastname: Lee
mesh_terms: D018926:Anti-Allergic Agents / Q000627:therapeutic use; D003888:Desensitization, Immunologic; D006801:Humans; D065631:Rhinitis, Allergic / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D018926:Anti-Allergic Agents
keywords: allergic rhinitis; environmental controls; immunotherapy; pharmacotherapy; quality of life measures