Prescribing patterns for allergic rhinitis in general practice setting: adherence to ARIA guidelines

Background: Allergic rhinitis (AR) and asthma are often co-morbidities. The correct management of AR should be ensured by the use of international ARIA (Allergic Rhinitis and its Impact on Asthma) guidelines (GL). Aim: To prospectively evaluate the adherence to GL of General Practitioners (GPs)for treating AR patients. Methods: Analyses concern 1197 patients (14-90 years, median 37) of 107 Italian GPs. Evaluation of appropriateness was based on ARIA GL, according to AR classification. Results: 44%of patients had concomitant asthma diagnosis. Among the 84 patients with moderate-severe persistent AR, 24% (18% of 40 with concomitant asthma) were prescribed antihistamines monotherapy. Among the 553 patients with mildintermittent AR, 42% (36% of 332 with only AR) were prescribed combined therapies. In general, the adherence to GL was 57% for patients with only AR and 46% for those with AR+asthma (p < 0.001). The adherence increased with increasing AR severity and reached 81% for the patients with moderate-severe persistent AR (89 and 95% for those with only AR or AR+asthma, respectively).