Symptom control and health-related quality of life in allergic rhinitis
with and without comorbid asthma: a multicentre European study
Abstract
Background: Allergic rhinitis (AR) is a major non-communicable
disease that affects the health-related quality of life (HRQoL) of
patients. AR is significantly related to asthma also affecting HRQoL.
However, data on HRQoL and symptom control in AR patients with comorbid
asthma are lacking. Objective: To assess the differences of
symptom control and HRQoL in AR patients with and without comorbid
asthma. Methods: In this multicentre, cross-sectional study,
patients with AR were screened and administered questionnaires of
demographic characteristics and health conditions (symptoms/diagnosis of
AR and asthma, disease severity level, and allergic conditions). HRQoL
was assessed using a modified version of the RHINASTHMA questionnaire
and symptom control was evaluated by a modified version of the Control
of Allergic Rhinitis/Asthma Test (CARAT). Results: Out of 643
patients with AR, 500 (78%) had asthma as a comorbidity, and 54% had
moderate-severe intermittent AR, followed by moderate-severe persistent
AR (34%). Patients with both AR and asthma had significantly higher
RHINASTHMA scores than the patients with AR alone (e.g., median
RHINASTHMA-total score 84 vs. 48.5, respectively). Conversely, CARAT
scores were significantly lower in AR with comorbid asthma than in the
patients with AR alone (median CARAT-total score 16.5 vs. 23,
respectively). Upon stratifying asthma based on severity, AR patients
with severe persistent asthma had worse HRQoL and control than AR
patients with mild persistent asthma. Conclusions: Our
observation of poorer HRQoL and symptoms control in AR patients with
comorbid asthma supports the importance of a comprehensive approach for
the management of AR in case of a comorbid allergic condition.