Quality of Life in Rhinoconjunctivitis Sufferers and the Effects of Topical Ocular Therapy

Abstract

Abstract: : Purpose: To analyze impact on quality of life (QOL) in rhinitis patients when topical ocular therapy is added to systemic and/or nasal medication regimens. Signs & symptoms of allergic rhinoconjunctivitis impact patients’ QOL, affecting work and school performance. Medication choice can influence degree of QOL improvement in these patients. Methods: Environmental, multi–center, open–label, crossover study design was used in this 3–visit 4–week study. 2 QOL instruments, the RQLQ and ACQLQ served as evaluatory criteria at visit 1 (baseline) and visits 2 & 3 (evaluation). Patients had prior diagnosis of rhinitis and were on stable doses of prescribed rhinitis treatment (nasal and/or systemic), which was continued throughout study. No patients were prior users of prescription ocular allergy therapy. Paired t–tests compared changes from baseline for RQLQ and ACQLQ. Results: Rhinitis patients experienced benefit with addition of topical ocular therapy (N=200). Prior medication regimens consisted of systemic antihistamine (AH) (∼50%), AH & nasal spray (33%), or nasal spray alone (16%). Clinically & statistically significant improvements in all 5 domains of ACQLQ were observed following the 2 week period of added ocular therapy (P<0.001). The largest improvements were evident in eye symptoms (1.39 unit change). Correlations betwen RQLQ and ACQLQ in overlapping domains did exist, with the highest correlation in the Eye Symptoms category (R=0.89). Conclusions: Allergic rhinitis patients experienced significant improvements in quality of life with addition of topical ophthalmic medication; this was most evident in ocular parameters of the RQLQ and ACQLQ, but was also evident globally, and in nasal symptom categories. The ocular component of the disease, and the broad surface area the ocular surface provides for the collection of allergens should not be overlooked when prescribing therapy regimens.

Keywords: quality of life • conjunctiva • clinical (human) or epidemiologic studies: health care delivery/economics/manpower