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      Quality of life in allergic rhinitis - children’s and their parents’ perspective in polish urban and rural population

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          Abstract

          Background

          Allergic rhinitis is a common chronic condition in the paediatric population. No reports regarding the quality of life in children with allergic rhinitis in the Polish population have been found in the available literature. The aim of this study was to assess and compare the quality of life in patients with allergic rhinitis reported by children and their parents living in a city and in rural areas, and to evaluate the possible relationships between the quality of life and the severity of symptoms.

          Methods

          Two hundred and eight children with allergic rhinitis participated in the study (89 girls, aged 6–17, mean age 11.7 ± 3). Children were asked to evaluate their rhinitis symptoms by using two scales: the Total 4 Symptom Score and the Visual Analogue Scale. The quality of life assessment included the KINDL-R questionnaire.

          Results

          Both for the T4SS and the VAS scale the severity of symptoms in children with seasonal rhinitis was significantly higher than in children allergic to perennial allergens. The quality of life total scores on the KINDL questionnaire was 45.6 ± 8.5 for the children and 73.7 ± 10.7 for the parents. In all the domains, except for physical health, the child’s quality of life was rated significantly higher by parents than by children. The biggest discrepancy occurred in the domains: social contacts and family.

          Conclusions

          Allergic rhinitis can disrupt the quality of life. Parents tend to overestimate their children’s quality of life comparing to the children’s own assessment. The quality of life in children with allergic rhinitis correlated with the severity of the clinical symptoms of the disease. Evaluation of the quality of life in children is an essential issue in clinical investigation of patients with allergic rhinitis. It is of great importance to ask children themselves about their quality of life than rely only on parental opinion.

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          Most cited references20

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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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            Global map of the prevalence of symptoms of rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three.

            Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC) measured the global patterns of prevalence and severity of symptoms of rhinoconjunctivitis in children in 1993-1997. International Study of Asthma and Allergies in Childhood Phase Three was a cross-sectional survey performed 5-10 years after Phase One using the same methodology. Phase Three covered all of the major regions of the world and involved 1 059 053 children of 2 age groups from 236 centres in 98 countries. The average overall prevalence of current rhinoconjunctivitis symptoms was 14.6% for the 13- to 14-year old children (range 1.0-45%). Variation in the prevalence of severe rhinoconjunctivitis symptoms was observed between centres (range 0.0-5.1%) and regions (range 0.4% in western Europe to 2.3% in Africa), with the highest prevalence being observed mainly in the centres from middle and low income countries, particularly in Africa and Latin America. Co-morbidity with asthma and eczema varied from 1.6% in the Indian sub-continent to 4.7% in North America. For 6- to 7-year old children, the average prevalence of rhinoconjunctivitis symptoms was 8.5%, and large variations in symptom prevalence were also observed between regions, countries and centres. Wide global variations exist in the prevalence of current rhinoconjunctivitis symptoms, being higher in high vs low income countries, but the prevalence of severe symptoms was greater in less affluent countries. Co-morbidity with asthma is high particularly in Africa, North America and Oceania. This global map of symptom prevalence is of clinical importance for health professionals.
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              Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines.

              The allergic rhinitis and its impact on asthma (ARIA) guidelines provide a new classification of allergic rhinitis, but a quantitative analysis for severity assessment is lacking. To study whether a visual analog scale (VAS) for global rhinitis symptoms could be used to assess the disease severity according to ARIA. Three thousand fifty-two allergic rhinitis patients seen in primary care were tested. Fifty three per cent had an objective diagnosis of allergy and 58% of the patients were treated. Patients were categorized according to ARIA guidelines. The severity of nasal symptoms was assessed using a VAS. Quality of life was measured using the rhinoconjunctivitis quality of life questionnaire (RQLQ). Severity had more impact on VAS levels than duration: mild intermittent rhinitis (3.5, 2.4-5.0 cm), mild persistent rhinitis (4.5, 3.2-5.6 cm), moderate/severe intermittent rhinitis (6.7, 5.3-7.7 cm) and moderate/severe persistent rhinitis (7.2, 6.1-8.2 cm). The receiver operating characteristic curve results showed that patients with a VAS of under 5 cm could be classified as 'mild' rhinitis (negative predictive value: 93.5%) and those with a VAS of over 6 cm as 'moderate/severe' rhinitis (positive predictive value: 73.6%). Receiver operating characteristic curves and a logistic regression showed that current treatment and allergy diagnosis have no effect on the assessment of rhinitis severity using VAS. Visual analog scale and the RQLQ global score were significantly correlated (rho = 0.46; P < 0.0001). A simple and quantitative method (VAS) can be used for the quantitative evaluation of severity of allergic rhinitis.
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                Author and article information

                Contributors
                hannasikorska@gmail.com
                bsoz@o2.pl
                Journal
                Health Qual Life Outcomes
                Health Qual Life Outcomes
                Health and Quality of Life Outcomes
                BioMed Central (London )
                1477-7525
                10 March 2020
                10 March 2020
                2020
                : 18
                : 64
                Affiliations
                GRID grid.4495.c, ISNI 0000 0001 1090 049X, 1st Department and Clinic of Paediatrics, Allergology and Cardiology, , Wroclaw Medical University, ; ul. Chalubinskiego 2a, 50-368 Wroclaw, Poland
                Article
                1315
                10.1186/s12955-020-01315-1
                7063775
                32156278
                79998e67-883a-4dc7-9ee8-ea7e24764613
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 29 March 2019
                : 3 March 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100009687, Uniwersytet Medyczny im. Piastów Slaskich we Wroclawiu;
                Award ID: STM.A220.17.048
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                Health & Social care
                allergic rhinitis,quality of life,children,t4ss,vas,kindl-r questionnaire
                Health & Social care
                allergic rhinitis, quality of life, children, t4ss, vas, kindl-r questionnaire

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