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

Olga Lourenço¹, Sinthia Bosnic-Anticevich², Elísio Costa³, João A Fonseca⁴, Enrica Menditto⁵, Biljana Cvetkovski², Vicky Kritikos², Rachel Tan², Anna Bedbrook⁶, Sophie Scheire⁷, Claus Bachert^{8

9

10}, Sławomir Białek¹¹, Vitalis Briedis¹², Koen Boussery⁷, G Walter Canonica¹³, Tari Haahtela¹⁴, Piotr Kuna¹⁵, Ettore Novellino¹⁶, Bolesław Samoliński¹⁷, Holger J Schünemann¹⁸, Dana Wallace¹⁹, Jean Bousquet^{6

20

21

22}

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, University of Sidney and Sydney Local Health District, Sydney 2037, Australia.
³ UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), University of Porto, 4150 Porto, Portugal.
⁴ CINTESIS, Center for Research in Health Technologies and Information Systems, Faculdade de Medicina da Universidade do Porto e MEDIDA, Lds., 4200-450 Porto, Portugal.
⁵ CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, 80138 Naples, Italy.
⁶ MACVIA-France, 34295 Montpellier, France.
⁷ Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
⁸ Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, 9000 Ghent, Belgium.
⁹ Sun Yat-sen University, International Airway Research Center, First Affiliated Hospital Guangzhou, Guangzhou 510275, China.
¹⁰ Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm and Department of ENT Diseases, Karolinska University Hospital, SE-171 76 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.
¹² Department of Clinical Pharmacy of Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
¹³ Personalized Medicine Clinic Asthma & Allergy, Humanitas University, Humanitas Research Hospital, 20089 Rozzano MI, Italy.
¹⁴ Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, 00100 Helsinki, Finland.
¹⁵ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Łódź, 90-419 Łódź, Poland.
¹⁶ Department of Pharmacy of the University of Naples Federico II, 80138 Naples, Italy.
¹⁷ Department of Prevention of Environmental Hazards and Allergology, Warsaw Medical University, 02-091 Warsaw, Poland.
¹⁸ Department of Health Research Methods, Evidence, and Impact, Division of Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹⁹ Nova Southeastern University, Fort Lauderdale, FL 33314, USA.
²⁰ Centre Hospitalier Universitaire de Montpellier, 34295 Montpellier, France.
²¹ Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, 10117 Berlin, Germany.
²² Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, 10178 Berlin, Germany.

PMID: 32429362
PMCID: PMC7355936
DOI: 10.3390/pharmacy8020085

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

Olga Lourenço et al. Pharmacy (Basel). 2020.

. 2020 May 16;8(2):85.

doi: 10.3390/pharmacy8020085.

Authors

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, University of Sidney and Sydney Local Health District, Sydney 2037, Australia.
³ UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (AgeUPNetWork), University of Porto, 4150 Porto, Portugal.
⁴ CINTESIS, Center for Research in Health Technologies and Information Systems, Faculdade de Medicina da Universidade do Porto e MEDIDA, Lds., 4200-450 Porto, Portugal.
⁵ CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, 80138 Naples, Italy.
⁶ MACVIA-France, 34295 Montpellier, France.
⁷ Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
⁸ Upper Airways Research Laboratory, ENT Dept, Ghent University Hospital, 9000 Ghent, Belgium.
⁹ Sun Yat-sen University, International Airway Research Center, First Affiliated Hospital Guangzhou, Guangzhou 510275, China.
¹⁰ Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm and Department of ENT Diseases, Karolinska University Hospital, SE-171 76 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.
¹² Department of Clinical Pharmacy of Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
¹³ Personalized Medicine Clinic Asthma & Allergy, Humanitas University, Humanitas Research Hospital, 20089 Rozzano MI, Italy.
¹⁴ Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, 00100 Helsinki, Finland.
¹⁵ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Łódź, 90-419 Łódź, Poland.
¹⁶ Department of Pharmacy of the University of Naples Federico II, 80138 Naples, Italy.
¹⁷ Department of Prevention of Environmental Hazards and Allergology, Warsaw Medical University, 02-091 Warsaw, Poland.
¹⁸ Department of Health Research Methods, Evidence, and Impact, Division of Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada.
¹⁹ Nova Southeastern University, Fort Lauderdale, FL 33314, USA.
²⁰ Centre Hospitalier Universitaire de Montpellier, 34295 Montpellier, France.
²¹ Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, 10117 Berlin, Germany.
²² Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, 10178 Berlin, Germany.

PMID: 32429362
PMCID: PMC7355936
DOI: 10.3390/pharmacy8020085

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.

Keywords: allergic rhinitis; community pharmacy; pharmacist.

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Conflict of interest statement

O Lourenço, E Costa, JA Fonseca, E Menditto, B Cvetkovski, R Tan, A Bedbrook, S Scheire, C Bachert, S Bialek, V Briedis, K Boussery, GW Canonica have no conflicts of interest to declare.

S Bosnic-Anticevich reports grants from TEVA, personal fees from TEVA, Boehringer Ingelheim, Sanofi, GSK, AstraZeneca, outside the submitted work.

V Kritikos reports personal fees from AstraZeneca, GlaxoSmithKline, Pfizer, outside the submitted work.

T Haahtela reports personal fees from Mundipharma, Novartis, and Orion Pharma, outside the submitted work.

P Kuna reports personal fees from Adamed, Boehringer Ingelheim, AstraZeneca, personal fees from Chiesi, FAES, Berlin Chemie, Novartis, Polpharma, Allergopharma, outside the submitted work.

D Wallace reports and Indicates that she is the co-chair of the JointTask Force on Practice Parameters, a task force composed of 12 members of the American Academy of Allergy, Asthma, and Immunology and the American College of Allergy, Asthma, and Immunology.

JB reports personal fees and others from Chiesi, Cipla, Hikma, Menarini, Mundipharma, Mylan, Novartis, Sanofi-Aventis, Takeda, Teva, Uriach, others from Kyomed, outside the submitted work.

Figures

**Figure 1**
Recognising allergic rhinitis in the pharmacy (adapted from [21,22]). In Figure 1, some of the items not associated with allergic rhinitis symptoms refer to rhinosinusitis and other diseases that need to be checked during differential diagnosis.

**Figure 2**
Screening of asthma in rhinitis patients in the pharmacy (Adapted from [22]).

**Figure 3**
Determining the impact of allergic rhinitis symptoms.

**Figure 4**
Treatment of allergic rhinitis in the pharmacy. AH, antihistamine; INAH, intranasal antihistamine; INCS, intranasal corticosteroid; IOAH, intraocular antihistamine. *INCS if coexisting asthma (adapted from [22]).

See this image and copyright information in PMC

References

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

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

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Conflict of interest statement

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