300 million people 3.3 MILLION PEOPLE2

Allergic rhinitis affects approximately 30 % of the Irish population2

300 million people AIRBORNE ALLERGENS DIFFICULT TO AVOID

The nose is the gateway to the respiratory tract and rhinitis is associated with symptoms arising from the sinuses, middle ear, the nasopharynx and lower airways1. Although airborne allergens are difficult to avoid and there is only limited evidence for successful avoidance, some aspects of management may be improved by allergen identification4

300 million people 80% SUFFER FROM RHINITIS

Both allergic rhinitis and non-allergic rhinitis are risk factors for the development of asthma1. More than 80% of people with asthma also suffer from rhinitis10,11. Both allergic rhinitis and non-allergic rhinitis are risk factors for the development of asthma1

The benefits of allergy testing

Targeted management of atopic patients could reduce the healthcare burden5,6

Is there a suspicion of allergy?

Go beyond symptoms
and identify the cause

  • Avoid unnecessary prescriptions
  • Avoid unnecessary consultations/referrals
  • Reduce the prescription burden and save costs
  • Reduce time off school, college or work and reduce waiting lists
  • Save time, costs and help patients live a less encumbered life

- Early diagnosis of allergy
- Determine the right treatment plan



  • Reduce emergency admissions
  • Reduce unnecessary prescriptions, consultations and referrals
  • Improve control
  • Enable patients to take part in normal daily activities
  • Save time, costs and help patients live a less encumbered life

Active
management

  • Improve quality of life

Common allergens

Rhinitis history

Rhinitis usually presents as a blocked or runny nose. Other symptoms of rhinitis can include itchy nose, itchy mouth and lips, itchy red eyes, swollen eyelids, and swelling of the mouth/airways. Symptoms typically occur as a result of a trigger. It is important to consider rhinitis in patients with asthma, eczema, conjunctivitis, sinusitis, polyposis, upper respiratory tract infections, otitis media, sleeping disorders, and in children with learning and attention impairments.

Diagnosing allergy in rhinitis starts with a physical examination and an allergy-focused patient history8

An allergy-focused clinical history should be tailored to the presenting symptoms and age of the patient9

A few key questions will provide you with a detailed history and allow you to correctly manage your patient

Download an allergy-focused patient history form

Download

Testing & recommendations

Guided by the allergy-focused patient history, work through the most appropriate next steps:

Assess the need for testing

If the patient history suggests an IgE-mediated allergy, conduct a blood test (allergen-specific IgE), or by trained, competent clinical staff, in a clinical environment with sufficient clinical support and facilities to manage anaphylaxis, a skin prick test can be performed.9 Specific IgE testing can be performed on any patient irrespective of age, allergic symptoms (i.e. eczema) and medication.

When taking blood for a test a 1 ml sample of whole blood is sufficient to test for up to 10 different allergens.

Interpretation of test results

Results should be read in conjuction with the clinical history.

Management & referral

The burden of atopic disease

Prof Somnath Mukhopadhyay discusses the burden of allergy.

The benefits of reducing allergen exposure

Avoidance or reduction in exposure to allergens can alleviate or reduce symptoms. In patients with asthma, alleviating the symptoms of rhinitis can help control the symptoms of asthma.

Printable action plans

Following diagnosis, to ensure your patient follows your management advice, it is important to provide them with an action plan.

Download these useful action plans to guide your management of allergy patients:

References
  1. Scadding GK, et al. Clin Exp Allergy 2008; 38: 19-42.
  2. Irish Medical Times. Update on Allergic Rhinitis. Available from www.imt.ie/clinical/2013/05/clinical-update-on-allergic-rhinitis.html; last accessed August 2016.
  3. Angier E, et al. Prim Care Respir J 2010; 19: 217-222.
  4. Allen-Ramey F, et al. J Am Board Fam Pract 2005;18(5):434-439.
  5. Host A, Halken S. Allergy 2000;55:600-608.
  6. House of Lords, Science and Technology sixth report- the extent and burden of allergy in the United Kingdom. Available from www.bsaci.org/pdf/HoL_science_report_vol.1.pdf; last accessed February 2014.
  7. Pearce L. Nursing Times 2012; 108(17): 20-22.
  8. Pawankar (Ed) et al. White book on allergy, 2011; World Allergy Organisation UK.
  9. National Institute for Health and Care Excellence. Food allergy in children and young people (CG116). 2011. London: National Institute for Health and Care Excellence.