Bunupuradah Torsak, Siriaksorn Sudawan, Hinds David, Shantakumar Sumitra, Mulgirigama Aruni, Aggarwal Bhumika
GlaxoSmithKline Limited, Bangkok, Thailand.
Chiang Mai Ram Hospital, Chiang Mai, Thailand.
Asia Pac Allergy. 2019 Jul 9;9(3):e24. doi: 10.5415/apallergy.2019.9.e24. eCollection 2019 Jul.
Underdiagnosis and undertreatment of allergic rhinitis (AR) in patients with asthma can worsen treatment outcomes. There is limited evidence of clinical practices for management of coexistent AR-asthma in Thailand.
A multicountry, cross-sectional study (Asia-pacific Survey of Physicians on Asthma and allergic Rhinitis) to evaluate physician perceptions and management practices related to AR-asthma overlap in 6 Asian countries was conducted. For Thailand specifically, AR-asthma linkage questionnaires were developed and translated to Thailaland. General physicians (GPs) or pediatricians, randomly selected from hospitals in urban cities, routinely treating >10 asthma patients/month were interviewed. Here we present the results for Thailand.
Two hundred physicians (100 GPs and 100 pediatricians), of whom 70% worked in government hospitals, were interviewed. In their experience, 50% of asthma patients had AR and 28% of AR patients had asthma. Among diagnosed asthma patients, 65% of physicians routinely asked for any AR symptoms at every visit. Among diagnosed AR patients, 63% of physicians routinely asked for any asthma symptoms at every visit. In patients with coexisting AR-asthma, 91% of physicians treated both diseases simultaneously, while 6% of physicians treated asthma as a chronic disease but managed AR symptomatically. The most preferred treatment options for patients with AR-asthma were inhaled corticosteroids with intranasal steroids (46% in GPs, 71% in pediatricians).
The physicians interviewed in Thailand are aware about coexistent asthma-AR. There is a need to increase the awareness further for coexistent AR-asthma and to educate nonspecialist physicians in the proper management of AR-asthma patients.
哮喘患者中过敏性鼻炎（AR）的诊断不足和治疗不足会使治疗效果恶化。在泰国，关于合并存在的AR-哮喘的临床管理实践证据有限。
开展了一项多国横断面研究（亚太地区哮喘和过敏性鼻炎医生调查），以评估6个亚洲国家医生对AR-哮喘重叠的认知和管理实践。具体针对泰国，开发了AR-哮喘关联问卷并翻译成泰语。从城市医院中随机选取每月常规治疗超过10例哮喘患者的全科医生（GPs）或儿科医生进行访谈。在此我们呈现泰国的研究结果。
共访谈了200名医生（100名全科医生和100名儿科医生），其中70%在政府医院工作。根据他们的经验，50%的哮喘患者患有AR，28%的AR患者患有哮喘。在已诊断的哮喘患者中，65%的医生每次就诊时都会常规询问是否有任何AR症状。在已诊断的AR患者中，63%的医生每次就诊时都会常规询问是否有任何哮喘症状。在合并存在AR-哮喘的患者中，91%的医生同时治疗这两种疾病，而6%的医生将哮喘作为慢性病治疗，但对症处理AR症状。AR-哮喘患者最常用的治疗方案是吸入性糖皮质激素联合鼻用糖皮质激素（全科医生中为46%，儿科医生中为71%）。
在泰国接受访谈的医生了解哮喘与AR合并存在的情况。有必要进一步提高对合并存在的AR-哮喘的认识，并对非专科医生进行AR-哮喘患者正确管理的教育。
