Chantaphakul Hiroshi, Chiewchalermsri Chirawat, Mairiang Dara, Lao-Araya Mongkol, Piboonpocanun Orathai, Nanthapisal Sira, Mitthamsiri Wat, Kamchaisatian Wasu, Manuyakorn Wiparat, Sangsupawanich Pasuree
Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Department of Medicine, King Chulalongkorn Memorial Hospital / The Thai Red Cross Society, Bangkok, Thailand.
J Allergy Clin Immunol Glob. 2025 Feb 19;4(2):100444. doi: 10.1016/j.jacig.2025.100444. eCollection 2025 May.
Allergic rhinitis (AR) and chronic urticaria impose significant socioeconomic burdens on lower-income countries. Despite the availability of evidence-based guidelines, their implementation varies, and comprehensive data on these allergic conditions are notably lacking in Thailand.
We sought to describe current management strategies for AR and urticaria in Thailand.
The Allergy, Asthma, and Immunology Association of Thailand used a modified Delphi method to explore consensus on management strategies for AR and urticaria. Clinicians with expertise in these conditions provided input through a web-based questionnaire. The survey assessed disease burden in Thailand, its impact on quality of life, and the use of H-antihistimine treatment options.
In total, 105 experts, mainly in allergy and immunology, with 70% having more than 10 years of clinical practice, provided input. Consensus was achieved on 22 (88%) of the 25 statements. Second-generation antihistamines were preferred as initial treatment for AR and urticaria because of their reduced sedation and lack of anticholinergic effects. Almost all participants (98.1%) recommended these antihistamines for acute and chronic urticaria. Additionally, 87.6% of the respondents favored up-dosing a single antihistamine agent for managing chronic urticaria. The benefits of orally disintegrating antihistamines were particularly noted for their ease of administration and patient compliance.
Results indicate a knowledge gap in evidence-based practices among Thai clinicians. Addressing this gap through enhancing clinical guideline adherence and encouraging pharmacist involvement in patient care can improve access to medication and better disease management, ultimately improving patient outcomes while reducing the socioeconomic burden of AR and urticaria.
变应性鼻炎（AR）和慢性荨麻疹给低收入国家带来了巨大的社会经济负担。尽管有循证指南，但在不同地区的实施情况各异，泰国尤其缺乏关于这些变应性疾病的全面数据。
我们试图描述泰国目前针对AR和荨麻疹的管理策略。
泰国变态反应、哮喘和免疫学协会采用改良德尔菲法探讨AR和荨麻疹管理策略的共识。这些领域的临床专家通过在线问卷提供意见。该调查评估了泰国的疾病负担、其对生活质量的影响以及H-抗组胺药治疗方案的使用情况。
共有105位专家提供了意见，主要来自变态反应和免疫学领域，70%的专家有超过10年的临床经验。25条陈述中有22条（88%）达成了共识。第二代抗组胺药因其镇静作用减弱且无抗胆碱能作用，被优先作为AR和荨麻疹的初始治疗药物。几乎所有参与者（98.1%）推荐这些抗组胺药用于急性和慢性荨麻疹。此外，87.6%的受访者赞成增加单一抗组胺药的剂量来治疗慢性荨麻疹。口腔崩解抗组胺药因其给药方便和患者依从性好而备受关注。
结果表明泰国临床医生在循证实践方面存在知识差距。通过加强临床指南的遵循并鼓励药剂师参与患者护理来弥补这一差距，可改善药物可及性并更好地管理疾病，最终改善患者预后，同时减轻AR和荨麻疹的社会经济负担。
