Sarcouncil Journal of Medical Sciences

Abstract: Background: Allergic rhinitis is a very common chronic inflammatory disease that significantly reduces the quality of life (HRQoL). However, there are still no adequate demarcations of how the severity of the disease downregulates patient-reported outcomes. The current study aimed at determining the impacts of the severity of allergic rhinitis on HRQoL and the functional status of adults attending an outpatient clinic. Methods: The study was an observational cross-sectional study that examined 170 adults from Iraq whose case of allergic rhinitis was diagnosed by a physician. Stratification, according to ARIA criteria, was done by dividing participants into two equal groups, Group I (patients with mild-moderate intermittent or persistent disease, n=85) and Group II (patients with moderate-severe persistent disease, n=85). Extensive demographic and clinical aspects, the duration of the disease, comorbidities such as asthma, chronic sinusitis, atopic dermatitis, and food allergy were cumulatively collected. Also, absenteeism at work and school over the last three months, presenteeism, emotional and social consequences, existing pharmacotherapeutic training, and self-reported medication adherence had been recorded. The statistical comparisons of cohorts were conducted with the help of the relevant parametric and non-parametric tests; the multivariate logistic regression was used to determine independent predictors of poor QoL. Findings: The two groups were similar in terms of age, gender distribution, living status, and smoking habits. Group II had a significantly higher mean RQLQ total score than Group I (about 4.3 versus 2.8 on a 0 6 scale), and the most significant differences were found in the domains of nasal symptoms and sleep. Group II patients indicated more days out of school or out of work, more productivity loss, more irritability and embarrassment, and more frequent social avoidance and a decrease in outdoor activities. Whereas intranasal corticosteroids, combination therapy, and allergen immunotherapy were more frequently used in Group II, the overall compliance was considerably decreased. Under multivariable analysis, under Group II, the independent predictors of poor QoL included prolonged disease duration, asthma comorbidity, and poor adherence, without statistical significance of age and sex. These results highlight the urgency to identify the patients at high risk early, systematically use proven QoL measures, combine the management of both upper and lower airway disease, and adopt patient-centered approaches that will result in better treatment adherence to reduce the overall effect of allergic rhinitis on the lives of patients.