title: The patient with rhinitis in the pharmacy. A cross-sectional study in real life.
abstract: BACKGROUND
  In the practical management of allergic rhinitis (AR), pharmacists are usually the first-line contact, also because some medications are available as over the counter. Therefore, pharmacists may represent an important resource, in mediating the interaction between patients and physicians. We evaluated the clinical/demographic characteristics of patients with respiratory allergies who consulted their pharmacists as first-line contact. A patient-oriented questionnaire was developed by a scientific committee including pharmacists, GPs, allergists, pulmonologists and ENT specialists.
  
  
  METHODS
  The questionnaire consisted of items covering the general aspects of AR. Allergic Rhinitis and its Impact on Asthma guidelines were assumed as reference for diagnosis and therapy. The questionnaire was distributed to pharmacies, and pharmacists were asked to deliver the questionnaire to all patients referring for nasal symptoms.
  
  
  RESULTS
  30 pharmacies were involved during the pollen season 2011, and 410 patients (55 % male) participated. The most frequent complaints were 20 rhinitis (49 %) and conjunctivitis (29 %), followed by lower respiratory symptoms (cough and/or dyspnea). Isolated conjunctival symptoms were present in only 22 % of patients. Among patients with lower respiratory symptoms, cough was the most frequent, variously associated with upper respiratory symptoms or overt dyspnea. Dyspnea alone was present in 16 % of patients. 39 % of patients had no physician-based diagnosis. Oral antihistamines were the most used self-medication, followed by intranasal decongestants. 30 % of respondents had used alternative medicines.
  
  
  CONCLUSIONS
  According to these data, AR is still considered a trivial disease, frequently self-managed, with over the counter medications, not in line with guidelines. A physician-based diagnosis is present in about 60 % of patients.
authors.affiliation: Unit of Allergy-Clinical Immunology & Respiratory Diseases - Department of Medicine & Geriatrics, Poliambulanza Hospital Institute, Brescia, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Lombardi
authors.affiliation: Unit of Allergy-Clinical Immunology & Respiratory Diseases - Department of Medicine & Geriatrics, Poliambulanza Hospital Institute, Brescia, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Musicco
authors.affiliation: President of the Order of Pharmacists of Brescia, Brescia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rastrelli
authors.affiliation: General Practitioner, Brescia, National Responsible for the Pulmonology Area of the Italian Society of General Practitioners (SIMMG), Brescia, Italy.
authors.forename: Germano
authors.initials: G
authors.lastname: Bettoncelli
authors.affiliation: Allergy & Respiratory Diseases, Department of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
authors.affiliation: Allergy & Respiratory Diseases, Department of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: Giorgio Walter
authors.initials: GW
authors.lastname: Canonica
keywords: Allergic asthma; Allergic rhinitis; Pharmacist; Respiratory allergy