COmorbid Asthma and Allergic Rhinitis: Clinicians’ EXperIence and ASsessmenT (CO-EXIST) Survey in Myanmar

Asthma and Allergic Rhinitis (AR) are highly prevalent comorbid conditions across the globe. However, there is a paucity of data regarding comorbid asthma and AR (CAAR) in Myanmar. This cross-sectional, observational survey evaluated clinicians’ (CLs; n=101) practice and experience in diagnosis and management of their patients with CAAR. 51% CLs observed nasal congestion as the most prominent symptom in CAAR. 44% CLs believed that CAAR patients were more likely to have frequent unplanned doctor visits compared to patients with only asthma (32%) or AR (20%). 89% of CLs performed neither skin prick test nor serum IgE levels in their patients and 85% of them relied only on clinical observations for diagnosing asthma. 73% of CLs observed maximum of their CAAR patients possessed moderate asthma severity. Post-nasal drip and nasal polyps were not so commonly reported by CLs in CAAR patients. 46% of CLs preferred to manage both conditions simultaneously. At least 35% of CLs believed that their patients preferred oral over inhaled corticosteroid (ICS) and intra-nasal corticosteroid (INCS) in CAAR. Concomitant administration of ICS with either INCS (42%) or anti-leukotrienes (32%) were the most preferred options among CLs in CAAR. 97% CLs prescribed INCS to all or few of their CAAR patients and follow up every month for seasonal (59%) and perennial AR (38%). CO-EXIST survey showed that utilization of diagnostic tools like spirometry, skin prick test, serum IgE levels could improve diagnosis. Most clinicians managed both asthma and AR simultaneously and ICS were the most frequently used drug with other treatments to manage it.