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Current Burden of Allergic Rhinitis and Urticaria
Allergic rhinitis (AR) and chronic urticaria are significant health concerns in Thailand, affecting a substantial portion of the population. Recent estimates suggest that AR impacts 10% to 40% of individuals globally, with similar trends observed in Thailand. The condition is characterized by nasal congestion, sneezing, runny nose, and itching, significantly impairing the quality of life (Chantaphakul et al., 2025). Furthermore, chronic urticaria, affecting approximately 1% of the population, presents as itchy hives and poses management challenges, particularly in low- and middle-income countries (Chantaphakul et al., 2025).
In Thailand, the socioeconomic burden of these allergic conditions is exacerbated by limited access to effective treatment and healthcare resources. As the prevalence of allergic diseases continues to rise, it is crucial to understand the management strategies currently employed by healthcare professionals in the region. The Allergy, Asthma, and Immunology Association of Thailand (AAIAT) recently conducted a modified Delphi study to gather insights into the treatment approaches for AR and urticaria among Thai clinicians.
Antihistamine Treatment Options for Allergic Conditions
Antihistamines remain the cornerstone of pharmacological management for allergic rhinitis and urticaria. The consensus among Thai healthcare providers favors the use of second-generation antihistamines due to their improved safety profile, which minimizes sedation and anticholinergic effects compared to first-generation antihistamines (Chantaphakul et al., 2025). A recent survey revealed that 98.1% of experts recommend second-generation antihistamines for acute and chronic urticaria, reinforcing their importance in clinical practice.
The preference for second-generation antihistamines stems from their efficacy in alleviating allergic symptoms without the sedative side effects that often hinder daily functioning. The AAIAT study indicated that 87.6% of participants support an up-dosing strategy of a single antihistamine agent for managing chronic urticaria, thereby enhancing treatment effectiveness. Notably, orodispersible tablets (ODTs) of antihistamines were recognized for their advantages in administration, particularly for populations with swallowing difficulties, including children and the elderly.
Table 1: Antihistamine Preferences Among Thai Clinicians
| Antihistamine Type | Percentage of Recommendation |
|---|---|
| Second-Generation Antihistamines | 98.1% |
| First-Generation Antihistamines | 14.3% |
| ODTs for Antihistamines | 87.6% |
Consensus on Best Practices for Managing Allergic Rhinitis
The modified Delphi study revealed that a significant majority of clinicians (88%) reached consensus on various management strategies for AR and urticaria. These strategies include the following:
- Use of Second-Generation Antihistamines: Second-generation antihistamines are recommended as the first-line treatment for both AR and urticaria, attributed to their minimal adverse effects and efficacy in symptom relief.
- Individualized Treatment Plans: Clinicians emphasized the need for personalized treatment approaches based on the patient’s clinical presentation and specific symptoms.
- Patient Education and Compliance: Ensuring that patients are well-informed about their condition and treatment options is essential for improving compliance and therapeutic outcomes.
The findings highlight a knowledge gap in the implementation of evidence-based practices among Thai clinicians, indicating an urgent need for educational initiatives to bridge this gap and optimize patient care.
Enhancing Patient Compliance with Antihistamine Prescriptions
Patient compliance with antihistamine prescriptions is a critical factor influencing treatment success. The AAIAT study found that 36.2% of clinicians advocated for the use of ODTs as a means to enhance compliance, particularly among populations who may struggle with traditional tablet forms. The convenience of ODTs can lead to better adherence to treatment regimens, especially in pediatric and elderly populations.
Furthermore, providing education about the importance of adhering to prescribed antihistamine regimens can improve compliance rates. Clinicians must engage patients in discussions about their treatment options, potential side effects, and the benefits of consistent use of antihistamines. This approach not only empowers patients but also fosters a collaborative relationship between patients and healthcare providers.
Table 2: Factors Influencing Patient Compliance
| Factor | Impact on Compliance |
|---|---|
| Use of ODTs | Positive |
| Patient Education | Positive |
| Clear Communication with Clinicians | Positive |
Conclusion
The management of allergic rhinitis and urticaria in Thailand presents unique challenges and opportunities for improvement. The recent AAIAT consensus highlights the importance of utilizing second-generation antihistamines and emphasizes the need for individualized treatment plans and patient education to enhance compliance. Bridging the knowledge gap among clinicians regarding evidence-based practices will be fundamental in optimizing treatment outcomes and reducing the socioeconomic burden associated with these allergic conditions.
FAQ Section
What are the common treatments for allergic rhinitis and urticaria?
Common treatments include second-generation antihistamines, which are preferred due to their efficacy and lower sedative effects. Corticosteroids may also be prescribed for severe cases.
Why are second-generation antihistamines preferred over first-generation ones?
Second-generation antihistamines are preferred because they cause less sedation and have fewer side effects, making them more suitable for daily use.
How can patients improve compliance with antihistamine treatment?
Patients can improve compliance by understanding their treatment plan, being educated about the benefits of the medications, and utilizing forms of antihistamines that are easier to take, such as orodispersible tablets.
Is there a gap in knowledge among Thai clinicians regarding allergy management?
Yes, the recent study indicates a significant knowledge gap in implementing evidence-based practices for managing allergic rhinitis and urticaria among Thai clinicians.
What role does patient education play in allergy management?
Patient education is crucial as it empowers individuals to understand their conditions and treatment options, leading to improved adherence and better health outcomes.
References
- Chantaphakul, H., Chiewchalermsri, C., Mairiang, D., Lao-Araya, M., Piboonpocanun, O., Nanthapisal, S., Mitthamsiri, W., Kamchaisatian, W., Manuyakorn, W. (2025). Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study. The Journal of Allergy and Clinical Immunology: Global
