The prevalence and severity of allergic rhinitis in primary care

<bold>Background:</bold> The prevalence of allergic rhinitis (AR) is increasing, and the costs of undiagnosed and insufficiently treated AR are high on both an individual and societal level. <bold>Aims:</bold> i) estimate the prevalence, ii) assess the severity, and iii) estimate the proportion of patients potentially eligible for allergen immunotherapy (AIT). <bold>Methods:</bold> 11 primary care clinics across various regions of Denmark participated in the study, covering 41,588 adult individuals. A pre-specified search algorithm in the electronic patient records was used to identify patients treated with anti-allergic medications. The patients then received a questionnaire on symptoms, medical history, diagnostic work-up and medications. <bold>Results:</bold> The overall prevalence of AR was 14.6%. 1,014 patients participated in the questionnaire survey (17% response rate), 60% were women, and the mean age was 53 (SD 16). 19% had been examined with skin prick test and 40% with sIgE. The most common symptoms were runny nose (64%), itchy eyes (57%), and sneezing (54%). A substantial proportion also reported tiredness (48%), sleep disturbances (29%), and loss of concentration (18%). One-third of the patients received anti-asthmatic medication. 633 patients (62%) had a symptom severity of VAS ≥ 5, and these patients were younger, 50 years (SD 16) vs 59 years (SD 14), p-value <0.05 and had higher use of anti-allergic medication, including systemic steroids, 8% versus 1%, p-value < 0.05. <bold>Conclusion:</bold> The overall prevalence of AR in primary care is 14.6%. Despite the high burden of symptoms, only half of the patients have undergone a diagnostic test. Among patients using nasal steroids, 74% had a VAS ≥ 5, suggesting a high number of patients potentially eligible for AIT.