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      Managing Allergic Rhinitis in the Pharmacy: An ARIA Guide for Implementation in Practice

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          Abstract

          The paradigm of how we manage allergic rhinitis is shifting with a growing understanding that it is a complex process, requiring a coordinated effort from healthcare providers and patients. Pharmacists are key members of these integrated care pathways resolving medication-related problems, optimizing regimens, improving adherence and recommending therapies while establishing liaisons between patients and physicians. Community pharmacists are the most accessible healthcare professionals to the public and allergic rhinitis is one of the most common diseases managed by pharmacists. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines developed over the past 20 years have improved the care of allergic rhinitis patients through an evidence-based, integrated care approach. In this paper, we propose an integrated approach to allergic rhinitis management in community pharmacy following the 2019 ARIA in the pharmacy guidelines.

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          Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision.

          Allergic rhinitis (AR) affects 10% to 40% of the population. It reduces quality of life and school and work performance and is a frequent reason for office visits in general practice. Medical costs are large, but avoidable costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines in 2010, prompting its update.
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            EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists

            The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.
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              The diagnosis and management of rhinitis: an updated practice parameter.

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                Author and article information

                Journal
                Pharmacy (Basel)
                Pharmacy (Basel)
                pharmacy
                Pharmacy: Journal of Pharmacy Education and Practice
                MDPI
                2226-4787
                16 May 2020
                June 2020
                : 8
                : 2
                : 85
                Affiliations
                [1 ]Faculty of Health Sciences and CICS—UBI, Health Sciences Research Centre, University of Beira Interior, 6200-506 Covilhã, Portugal
                [2 ]Woolcock Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney 2037, Australia; sinthia.bosnic-anticevich@ 123456sydney.edu.au (S.B.-A.); biljana.cvetkovski@ 123456sydney.edu.au (B.C.); vicky.kritikos@ 123456sydney.edu.au (V.K.); rachel.sze.tan@ 123456sydney.edu.au (R.T.)
                [3 ]UCIBIO, REQUIMTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing (AgeUPNetWork), University of Porto, 4150 Porto, Portugal; emcosta@ 123456ff.up.pt
                [4 ]CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal; fonseca.ja@ 123456gmail.com
                [5 ]CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, 80138 Naples, Italy; enrica.menditto@ 123456unina.it
                [6 ]MACVIA-France, 34295 Montpellier, France; anna.bedbrook@ 123456inserm.fr
                [7 ]Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium; Sophie.Scheire@ 123456ugent.be (S.S.); koen.boussery@ 123456ugent.be (K.B.)
                [8 ]Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, 9000 Ghent, Belgium; claus.bachert@ 123456ugent.be
                [9 ]International Airway Research Center, First Affiliated Hospital Guangzhou, Sun Yat-sen University, Guangzhou 510275, China
                [10 ]Department of Medicine Solna, Immunology and Allergy Research Unit, Karolinska Institute, 171 77 Stockholm, Sweden
                [11 ]Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with the Division of Laboratory Medicine, Warsaw Medical University, 02-091 Warsaw, Poland; slawomir.bialek@ 123456wum.edu.pl
                [12 ]Department of Clinical Pharmacy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania; vitalis.briedis@ 123456lsmuni.lt
                [13 ]Personalized Medicine Clinic Asthma & Allergy, Humanitas University, Humanitas Research Hospital, 20089 Rozzano MI, Italy; giorgio_walter.canonica@ 123456hunimed.eu
                [14 ]Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, 00100 Helsinki, Finland; tari.haahtela@ 123456haahtela.fi
                [15 ]Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Łódź, 90-419 Łódź, Poland; piotr.kuna@ 123456umed.lodz.pl
                [16 ]Department of Pharmacy, University of Naples Federico II, 80138 Naples, Italy; ettore.novellino@ 123456unina.it
                [17 ]Department of Prevention of Environmental Hazards and Allergology, Warsaw Medical University, 02-091 Warsaw, Poland; boleslaw.samolinski@ 123456wum.edu.pl
                [18 ]Department of Health Research Methods, Evidence, and Impact, Division of Immunology and Allergy, McMaster University, Hamilton, ON L8S 4L8, Canada; holger.schunemann@ 123456mcmaster.ca
                [19 ]College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USA; drdanawallace@ 123456gmail.com
                [20 ]Centre Hospitalier Universitaire de Montpellier, 34295 Montpellier, France; jean.bousquet@ 123456orange.fr
                [21 ]Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117 Berlin, Germany
                [22 ]Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin Institute of Health, 10178 Berlin, Germany
                Author notes
                [* ]Correspondence: olga@ 123456fcsaude.ubi.pt ; Tel.: +351-275-329-009
                Author information
                https://orcid.org/0000-0002-8401-5976
                https://orcid.org/0000-0002-0887-8796
                https://orcid.org/0000-0001-9623-4458
                Article
                pharmacy-08-00085
                10.3390/pharmacy8020085
                7355936
                32429362
                4d99334b-be7f-4550-a03e-697be965b922
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 15 April 2020
                : 15 May 2020
                Categories
                Article

                allergic rhinitis,community pharmacy,pharmacist
                allergic rhinitis, community pharmacy, pharmacist

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