University of Sydney, Sydney, Australia.
Woolcock Institute, University of Sydney, Sydney, Australia.
NPJ Prim Care Respir Med. 2018 Jan 23;28(1):3. doi: 10.1038/s41533-018-0071-0.
Allergic rhinitis (AR) is sub-optimally managed in the community and is responsible for a significant health and economic burden. Uncontrolled AR increases the risk of poorly controlled asthma and presents an increased susceptibility to thunderstorm asthma. With the availability of treatments over-the-counter, bypassing the health care professional (HCP), the role of the patient is paramount. Research on the role of the patient in AR management in the current environment is limited. This study aims to explore the patient perspective of AR management and understand why it is sub-optimally managed in the community. Patient perspectives of AR management were explored utilizing a qualitative, phenomenological approach. Adults with AR were included in the study and interviewed. Transcripts were analyzed for recurrent themes and emergent concepts. Forty-seven participants with AR were interviewed about their experiences. Patient reports of delayed diagnosis, treatment fatigue and confidence in the ability to manage their AR themselves, heavily influenced their management preferences. Patients also described barriers associated with AR management including financial expense as well as being mistaken for having an infectious disease. Patients described examples of the impact on their quality of life caused by their AR, yet they strongly believed they could manage it themselves. This belief that AR is a condition that should be entirely self-managed, contributes to its burden. It amplifies patients' separation from HCPs and having access to guidelines aimed at optimizing their AR control.
变应性鼻炎（AR）在社区中的管理效果并不理想，给患者带来了沉重的健康和经济负担。未得到控制的 AR 会增加哮喘控制不佳的风险，并使患者更容易患上雷暴哮喘。由于可以在没有医疗保健专业人员（HCP）参与的情况下购买到治疗药物，患者的作用变得至关重要。然而，目前关于患者在 AR 管理中的作用的研究还很有限。本研究旨在探讨患者对 AR 管理的看法，并了解为什么其在社区中的管理效果不佳。
本研究采用定性、现象学方法来探索患者对 AR 管理的看法。研究纳入了患有 AR 的成年人，并对其进行了访谈。对转录本进行了反复主题和新兴概念的分析。
共有 47 名 AR 患者接受了关于其患病经历的访谈。患者报告的诊断延迟、治疗疲劳以及对自身管理 AR 能力的信心，对其管理偏好产生了重大影响。患者还描述了与 AR 管理相关的障碍，包括经济费用以及被误诊为传染病。患者描述了 AR 对其生活质量的影响，尽管他们坚信自己能够管理好病情。
这种认为 AR 是一种应该完全由患者自我管理的疾病的信念，加剧了其负担。这种信念加剧了患者与 HCP 之间的脱节，以及患者对旨在优化 AR 控制的指南的获取。
