Management of allergic rhinitis in UK primary care: baseline audit

Abstract

Background: : Evidence suggests that the UK primary care management of people with allergic rhinitis is sub-optimal. Common deficiencies are thought to include under-diagnosis, mis-diagnosis and sub-optimal treatment.

Objectives: : We sought to assess GPs' understanding and perspectives on key issues in the management of allergic rhinitis, comparing these with recommendations contained in the Consensus statement on the treatment of allergic rhinitis.

Methods: : Sampling frame of 210GPs with a self-declared interest in the management of allergic and respiratory disorders from 70GP practices in the UK. Semi-structured interviews were used to assess GPs' knowledge and views on clinical practice. Trained personnel conducted all interviews. Interviews were taped and transcribed; each transcript was scrutinised to see if GP knowledge and practice was consistent with the standards set. STANDARDS AND CRITERIA:: We used the most recent Consensus statement on the treatment of allergic rhinitis as our standard, aiming to assess quality of care in four main domains: identification of symptoms; collection of information to support a clinical diagnosis; examination and investigations performed to support the clinical diagnosis; treating and managing the condition.

Results: : We successfully interviewed 90% (n=188) of GPs. Only 14% (n=26) of GPs satisfied all the criteria set for Standard 1 (identification of symptoms); 23% (n=43) satisfied criteria for Standard 2 (collection of information to support a clinical diagnosis); 0% (n=0) satisfied criteria for Standard 3 (examination and investigations performed to support the clinical diagnosis); and 0.6% (n=1) satisfied criteria set for Standard 4 (adequate treatment issued).

Conclusions: : This national baseline audit of GPs with a self-declared interest in allergic and respiratory disorders reveals considerable scope for improvement in GP awareness and management of allergic rhinitis.