The role of patient training in the management of seasonal rhinitis and asthma: clinical implications

Background: Allergic rhinitis is an inflammatory disease often associated w ith bronchial asthma. Intranasal corticosteroids and oral antihistamines ar e the first-choice drugs. Patient training is relevant to asthma management , but little is known about its impact on rhinitis. We evaluated the role o f patient training in the treatment of allergic rhinitis and its effects on nasal and bronchial symptoms. Methods: One hundred and one patients (M/F = 62/39, age range 12-62 years) with pollen-induced rhinitis (32 with concomitant mild asthma) were enrolle d. They were randomized into three groups: A (n = 30) with drug therapy alo ne, B (n = 35) with drug; therapy plus training on the use of nasal spray, and C (n = 36) the same as B plus a lesson on rhinitis and asthma. All pati ents received mometasone furoate nasal spray for 8 weeks as regular therapy , plus rescue medications on demand. Symptoms and drug consumption were eva luated during the pollen season. Results: The rate of noncompliance/dropout was highest in the untrained pat ients (P = 0.001). No difference in nasal symptoms was seen among the three groups. On the other hand, group C had significantly fewer asthma symptoms (P = 0.02) and less albuterol use (P = 0.005) than group A. Moreover, the trained group globally used less rescue medication than the other groups (P = 0.02). Conclusions: Detailed training of patients seems to improve compliance with treatment, reduce concomitant asthma symptoms, and reduce the use of sympt omatic drugs.