Rhinitis management: the patient’s perspective

Seasonal allergic rhinitis causes considerable impairment of health-related quality of life (HQRL). Generic quality-of-life questionnaires enable a comparison to be made between patients with different illnesses, but they often have insufficient depth to measure specific problems that are important to an individual with a particular condition. In order to overcome these shortcomings, the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was developed. Eighty-nine patients, with a wide range of rhinoconjunctivitis severity, scored a list of 91 problems for importance. The highest-scoring problems were the practical problems: continually having to blow the nose, rub the nose and eyes, and carry tissues. Patients were also bothered by sleep impairments and systemic problems such as tiredness, poor concentration and thirst. Questionnaires have also been developed for adolescents (12-17 years of age)--finding similar results to those for adults--and children (6-12 years of age), who were troubled by their symptoms but did not have the emotional dysfunction experienced by adults and adolescents. All three questionnaires have strong measurement properties and have high reliability and good responsiveness, validity and interpretability. Quality-of-life questionnaires can be used in clinical studies to help elucidate which treatments are preferred by patients and the efficacy of treatment regimens. Disease-specific quality-of-life questionnaires can also be used during routine assessments and may reveal problems not spontaneously volunteered by patients, particularly children. Results can also be compared at each clinic visit to determine whether each intervention has been beneficial.