title: UK prescribing practices as proxy markers of unmet need in allergic rhinitis: a retrospective observational study.
abstract: Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing AR treatment effectiveness based on the prescribing behaviour of UK general practitioners (GP) during two consecutive pollen seasons (2009 and 2010). We conducted a retrospective observational study with the data from the Optimum Patient Care Research Database. We assessed diagnoses and prescription data for patients with a recorded diagnosis of rhinitis who took rhinitis medication during the study period. We assessed the data from 25,069 patients in 2009 and 22,381 patients in 2010. Monotherapy was the initial prescription of the season for 67% of patients with seasonal AR (SAR) and 77% of patients with nonseasonal upper airways disease (NSUAD), for both years. Initial oral antihistamine (OAH) or intranasal corticosteroid (INS) monotherapy proved insufficient for >20% of SAR and >37% of NSUAD patients. Multiple therapy was the initial prescription for 33% of SAR and 23% of NSUAD in both years, rising to 45% and >50% by season end, respectively. For NSUAD, dual-therapy prescriptions doubled and triple-therapy prescriptions almost tripled during both seasons. Many patients revisited their GP regardless of initial prescription. Initial OAH or INS monotherapy provides insufficient symptom control for many AR patients. GPs often prescribe multiple therapies at the start of the season, with co-prescription becoming more common as the season progresses. However, patients prescribed multiple therapies frequently revisit their GP, presumably to adjust treatment. These data suggest the need for more effective AR treatment and management strategies.
authors.affiliation: University of Aberdeen, Aberdeen, UK.|Research in Real Life, Oakington, Cambridge, UK.|Observational and Pragmatic Research Institute Pte Ltd, Singapore, SG.
authors.forename: David B
authors.identifier: 0000-0002-9728-9992
authors.initials: DB
authors.lastname: Price
authors.affiliation: The Royal National Throat, Nose and Ear Hospital, London, UK.
authors.forename: Glenis
authors.initials: G
authors.lastname: Scadding
authors.affiliation: Upper Airways Research Laboratory, Ghent University Hospital, Ghent, Belgium.
authors.forename: Claus
authors.initials: C
authors.lastname: Bachert
authors.affiliation: Imperial College NHS Healthcare, Charing Cross Hospital, London, UK.
authors.forename: Hesham
authors.initials: H
authors.lastname: Saleh
authors.affiliation: Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Shuaib
authors.initials: S
authors.lastname: Nasser
authors.affiliation: Optimum Patient Care Ltd, Cambridge, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Carter
authors.affiliation: Research in Real Life, Oakington, Cambridge, UK.
authors.forename: Julie
authors.initials: J
authors.lastname: von Ziegenweidt
authors.affiliation: Research in Real Life, Oakington, Cambridge, UK.
authors.forename: Alice M S
authors.initials: AM
authors.lastname: Durieux
authors.affiliation: Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
authors.forename: Dermot
authors.identifier: 0000-0002-4115-7376
authors.initials: D
authors.lastname: Ryan
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006633:Histamine Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D065631:Rhinitis, Allergic / Q000188:drug therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy; D006113:United Kingdom
chemical_list: D000305:Adrenal Cortex Hormones; D006633:Histamine Antagonists