Patient Expectations in Allergic Rhinitis Treatment: A Mixed-Methods Study

Ana Noreña-Peña,1,2 Fernando Mugarza Borque,2,3 Jorge Mestre-Ferrandiz,3 Jesús Diaz Olmo,2,3 Vicente F Gil-Guillén,2,4,5 Ramón Rodríguez Pacheco,6 María Mercedes Rizo-Baeza,1,2 Ernesto Cortés-Castell2,7 1Department of Nursing, University of Alicante, Alicante, Spain; 2Chair of the Patient, University of Alicante, Alicante, Spain; 3ProPatiens Institute, Madrid, Spain; 4Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain; 5Primary Care Research Center, Miguel Hernandez University, San Juan de Alicante, Spain; 6Allergology Department, General University Hospital of Elda, Alicante, Spain; 7Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernandez University, San Juan de Alicante, SpainCorrespondence: Ernesto Cortés-Castell, Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernandez University, Ctra. Alicante-Valencia s/n, San Juan de Alicante, 03550, Spain, Email [email protected]: Understanding patients’ expectations and needs regarding allergic rhinitis (AR) treatment is key to improving adherence and outcomes. A patient-centered approach that considers subjective treatment perceptions can provide valuable insights for improving disease management.Objective: To explore the subjective experience of patients with moderate to severe AR regarding their treatment, exploring expectations, needs, and adherence.Methods: An observational, descriptive, cross-sectional study with a mixed-methods design was conducted during the first four months of 2024 through the Spanish Federation of Associations of Allergy and Respiratory Disease Patients (FENAER). The study included a quantitative survey (56 questions) completed by 75 patients with moderate to severe AR and a qualitative focus group with 7 patients. The focus group explored key concerns, justifications, and proposed solutions.Results: The mean age of participants was 42.3 (SD21.7) years, with 65.3% of participants being female, 84% had moderate and 16% severe AR. Seventy-two percent reported symptom fluctuations since diagnosis, and 69% indicated an impact on daily activities, leisure, or sports. Side effects were reported by 18.6% of patients, all of whom informed their healthcare provider. While 73.3% were satisfied with their treatment, 33.3% had considered requesting a change, primarily due to perceived efficacy. More than half (54.7%) reported high adherence, yet 26.7% found treatment costs high. Regarding disease information, 58.6% found it useful, but 82.7% desired more education on AR and treatment options. The qualitative analysis revealed 15 key themes, including the need for individualized therapies, simpler administration methods, better communication with healthcare providers, emotional support, and the role of patient associations in facilitating education and adherence.Conclusion: This study highlights the need for a patient-centered approach in AR management. Beyond efficacy, factors such as ease of administration, side effects, and communication influence satisfaction and adherence. Involving patients in decisions may improve outcomes and quality of life.Keywords: allergic rhinitis, patient satisfaction, medication adherence, patient-centered care, focus groups