Impact of allergic rhinitis on the day-to-day lives of children: Insights from an Australian cross-sectional study

Sinthia Bosnic-Anticevich* (Corresponding Author), Peter Smith, Michael J. Abramson, Charlotte Hespe, Menai Johnson, Rodney Stosic, David Price

*Corresponding author for this work

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Abstract

Study design and objective: Cross-sectional, observational survey to describe the impact of allergic rhinitis (AR) on Australian children (2-15 years).Methods: Participants (N=1541), parents of children aged 2–15 years, providedinformation on behalf of themselves and one eligible child in their household using a custom-built online questionnaire. Children were allocated to case (AR) or control (No AR) analysis groups based on a validated screening questionnaire. Statistical methods: The study sample was stratified on age: primary analysis population (6-15 years, N=1111; AR=797, No AR=314); exploratory population (2-5 years).. The primary endpoint, parent-perceived burden, was quantified using a validated measure of health status and analysed via comparison of means.Results: The majority of AR cases were treated (730/797; 90.3%) and classified as having moderate-severe, intermittent AR (549/797; 68.9%). Half reported adequate symptom control in the prior 2 weeks (389/797; 48.8%; odds ratio=4.04; 95% confidence interval [CI] 2.24 to 7.31). Having AR was associated with worse overall health status (7.4 vs 8.4, mean difference [LSMD]=-0.99; 95%CI -1.18 to -0.79), fewer days being happy (22.2 vs 25.9, LSMD=-3.68; 95%CI -4.82 to -2.54) and more days of poor physical (2.82 vs 0.78, LSMD=2.04; 95%CI 1.61 to 2.47) and emotional(2.14 vs 0.67, LSMD=1.47; 95%CI 1.02 to -1.92) health compared with not havingAR. All of these outcomes were significantly (p<0.05) worse in children who reported inadequate symptom control. Having AR negatively impacted on schoolwork, sleep and other activities, and increased the likelihood of having comorbidities.Conclusion: The parent-perceived burden of AR in Australian children is high and itimpacts many areas of day-to-day living. Inadequate symptom control is a key driver of the extent of this impact. Opportunities to optimise the management of AR in children include the adoption of self-assessment tools to gauge and monitor adequacy of symptom control
Original languageEnglish
Article numbere038870
Number of pages12
JournalBMJ Open
Volume10
Issue number11
Early online date24 Nov 2020
DOIs
Publication statusPublished - 24 Nov 2020

Bibliographical note

Acknowledgements:
The authors would like to thank Dr Pascal Bourgeat for his input into the study design and statistical analysis plan, who passed away before the completion of the study fieldwork. Professional writing assistance in the preparation of this manuscript was provided by Hazel Palmer MSc, ISMPP CMPPTM of Scriptix Pty Ltd and statistical analyses were performed by Erika Graetz, MSc, of Ipsos Pty Ltd, both were funded by Sanofi Aventis Healthcare Australia Pty Ltd.
Funding:
This study was sponsored by Sanofi Aventis Healthcare Australia Pty Ltd, which had input into the concept, study design, data analyses, data interpretation, and preparation
of this report. The study sponsor markets fexofenadine (Telfast®). SBA, PS, DP,
MJA and CH received honoraria from Sanofi Aventis Healthcare Australia Pty Ltd for their involvement in an initial working group to determine the parameters of this research project. The authors were responsible for all content, the interpretation of the data, and the decision to publish the results; they received no honoraria related to the development of this manuscript. The sponsor funded statistical and editorial assistance and reviewed the final draft before submission. Statistical analyses were performed externally (Erika Graetz, MSc, of Ipsos Pty Ltd). Editorial assistance in the preparation of this manuscript was provided by Hazel Palmer, MSc, ISMPP CMPP™ of Scriptix Pty Ltd.

Keywords

  • allergy
  • paediatric thoracic medicine
  • quality in health care

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