Measuring health-related quality of life in rhinitis

Patients with rhinitis are bothered both by the nasal symptoms themselves and by associated symptoms such as headache and fatigue. The combination can produce quite severe impairment of day-to-day physical, emotional, occupational, and social functioning and can cause emotional distress. This breadth of impairment of health-related quality of life in patients with rhinitis is often not recognized and is sometimes trivialized by some health care professionals. One of the aims of treating patients with rhinitis must be to ensure that all individual patient problems are recognized and treated appropriately. Several studies now show that correlations between conventional nasal symptom-severity diaries and health-related quality of life are only weak to moderate. Therefore, to get an overall picture of a patient's health status, it is essential to measure quality of life. Genetic health-status questionnaires are able to compare burden of illness across different medical conditions, but they are often not responsive enough to small but clinically important changes in patients' quality of life. As a result, we have seen the emergence of disease-specific instruments for rhinitis that have strong measurement properties and that are much more sensitive to these changes. Most clinical trials in rhinitis now include a measure of health-related quality of life as a primary outcome, and many clinicians are incorporating quality of life into routine clinical assessments.