|Beitragstitel||Patient-reported improvement after treatment of allergic rhinitis is dominantly associated with post-treatment outcomes|
Aims: Patient-reported improvement in an outcome after treatment has been shown to be biased by post-treatment outcome, rather than the objective change in outcome. We sought to determine if this phenomenon occurred for allergic rhinitis (AR) control.
Materials and methods: This was a prospective observational study of 44 patients with persistent AR who were treated with a combination of antihistamines and intranasal corticosteroid spray. Data were collected at two time points: enrollment and a subsequent follow up visit 2 to 4 months later. AR control was measured using the Rhinitis Control Assessment Test (RCAT). At follow-up, participants rated the change in general health, as well as change in allergy symptoms each (the anchor questions) as “Much worse”, “A little worse”, “About the same”, “A little better” or “Much better”.
Results: The post-treatment RCAT score was associated with noticeable improvement (at least “A little better”) in general health (OR=1.36, 95%CI: 1.07–1.73, p=0.013) and allergy symptoms (OR=1.35, 95%CI: 1.08–1.69, p =0.009), while pre-treatment RCAT was not associated at all. A post-treatment RCAT score of 22, which coincidentally has been set as the threshold for good control, optimally and accurately identified patients experiencing improvement in general health (sensitivity: 82.4%, specificity: 63.0%) and allergy symptoms (sensitivity: 66.7%, specificity: 73.9%).
Discussion: Patient-noticed improvement, in relation to AR control, is heavily biased towards post-treatment—rather than change—in control. Independent of starting control, all AR patients needing treatment may therefore be able to achieve noticeable improvement.