Asthma with allergic rhinitis management in China: a nationwide survey of respiratory specialists at tertiary hospitals.
BACKGROUND
Many asthmatic patients have coexisting allergic rhinitis (AR). This study aims to investigate the compliance of physicians with respiratory medicine specialty (PRMs) to Global Initiative for Asthma (GINA) and Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines during the management of their asthma-AR patients.


METHODS
This cross-sectional questionnaire study surveyed the diagnostic methods and treatment patterns for asthma-AR comorbidity by PRMs from 98 hospitals across China.


RESULTS
PRMs reported an estimated prevalence of asthma-AR comorbidity of >30% at their clinics. PRMs with greater work experience and a higher professional title estimated treating a significantly higher proportion of patients with AR within the previous month (p = 0.002 and p < 0.001, respectively); they also estimated a higher incidence of patients with AR in the autumn (p < 0.001 and p < 0.001). A higher percentage of PRMs with ≥11 years work experience prescribed nasal steroids for AR as compared to those with 1 to 10 years experience (56.9% vs 44.7%, p = 0.002). A greater proportion of chief physicians used leukotriene modifiers and a lower proportion used antihistamine H1 -receptor blockers for AR as compared to residents (resident vs assistant chief: 27.5% vs 11.6%, p = 0.002; and resident vs chief PRMs: 27.5% vs 9.5%, p = 0.001).


CONCLUSIONS
PRMs in China demonstrated an up-to-date comprehension of asthma management (>90%); however, knowledge gaps existed in their concepts of AR and asthma-AR comorbidity. Thus, further education is warranted for PRMs regarding the importance of AR in asthma patients, definitive diagnosis (allergy tests), classifications of AR, and treatment guidelines for the asthma-AR comorbidity.
Department of Respiratory Diseases, China-Japan Friendship Hospital, Peking University, Beijing, China.
Nan
N
Su
Jiangtao
J
Lin
Guoliang
G
Liu
Kaisheng
K
Yin
Xin
X
Zhou
Huahao
H
Shen
Ping
P
Chen
Rongchang
R
Chen
Chuntao
C
Liu
Changgui
C
Wu
Jianping
J
Zhao
Yanping
Y
Lin
D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D008297:Male; D014663:Nasal Decongestants / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015272:Pulmonary Medicine / Q000706:statistics & numerical data*; D065631:Rhinitis, Allergic / Q000175:diagnosis / Q000188:drug therapy*; D012621:Seasons; D013256:Steroids / Q000627:therapeutic use
D018927:Anti-Asthmatic Agents; D006633:Histamine Antagonists; D020024:Leukotriene Antagonists; D014663:Nasal Decongestants; D013256:Steroids
ARIA; China; GINA; allergic rhinitis; asthma; asthma-allergic rhinitis comorbidity; disease management