Rhinitis: Clearing the Way to Better Patient Outcomes

General Information

Program Description

This CE program will provide an overview of: the prevalence and burden of disease and the latest information on effective treatments for patients with allergic and vasomotor rhinitis; how various nasal spray formulations affect patient preference and tolerability; and the implications of changes in OTC coverage in managed care.

Target Audience

Pharmacists and other pharmacy professionals

Needs Assessment

Rhinitis, an inflammation of the nasal mucosa, is a disorder that affects more than 40 million Americans.1,2 When allergic or nonallergic particles are inhaled nasally, it triggers the release of the chemical irritant histamine, the primary cause of rhinitis.

Airborne pollen and mold spores can cause allergic rhinitis, also known as hay fever, in both children and adults. More than 15% of the population has allergic rhinitis, which negatively affects the quality of life for many patients. Poor sleep and diminished work productivity are the biggest consequences of rhinitis, as many patients cannot obtain sufficient rest because of their symptoms.3 Recently, the total costs of allergic rhinitis were estimated at $5.3 billion annually.4

Aside from environmental allergens, other, nonallergic substances may also cause rhinitis. Unlike allergic rhinitis, nonallergic (vasomotor) rhinitis occurs when the body releases a variety of inflammatory mediators, including histamine, in response to inorganic airborne irritants, such as smoke, perfume, and car exhaust. Vasomotor rhinitis is believed to be an exaggeration of the usual nasal response to irritation, occurring at levels of exposure that most people do not notice.5 Often, patients, clinicians, and pharmacists cannot determine whether the rhinitis is allergic or vasomotor in origin. Patients are advised to avoid sources of irritating particulates where possible. Ocular disorders such as allergic conjunctivitis are often seen in association with rhinitis and also require effective management.

Although there is yet no cure for rhinitis, there are a variety of prescription and over-the-counter products to combat these bothersome symptoms. Patients may be prescribed medications such as antihistamines, decongestants, or corticosteroids, including the newer intranasal antihistamines and medications that can treat both allergic and vasomotor rhinitis. Recognizing the differences among nasal sprays can aid the pharmacist in counseling patients about their medication. Formulations of nasal sprays involving different expedients can have various effects on tolerability, efficacy, and patient satisfaction and compliance, such as affecting aftertaste or odor, increasing resonance time in the nose, or exerting an anti-inflammatory effect.

Pharmacists play a significant role in advising and counseling patients about their rhinitis medication, including over-the-counter products available, the correct way to administer the medication, adverse effects, how long it takes to see an effect, and issues involving compliance. Through an evidence-based educational program that provides a comprehensive overview of the most current therapies available as well as strategies for patient education and counseling, pharmacists can improve outcomes and quality of life for all rhinitis patients.

1. Quillen DM, Feller DB. Diagnosing rhinitis: allergic vs. nonallergic. Am Fam Physician. 2006;73:1583-1590.
2. Sly RM. Epidemiology of allergic rhinitis. Clin Rev Allerg Immunol. 2002;22:67-103.
3. Szeinbach SL, Seoane-Vazquez EC, Beyer A, et al. The impact of allergic rhinitis on work productivity. Prim Care Respir J. 2007;16:98-105.
4. Allergic rhinitis. e-Medicine. Available at: http://www.emedicine.com/med/byname/rhinitis-allergic.htm. Accessed June 5, 2007.
5. Settipane RA, Lieberman P. Update on nonallergic rhinitis. Ann Allergy Asthma Immunol. 2001;86:494-507.

Web cast Agenda

The web cast has 6 separate lectures to view:

Welcome Introduction - Randall D. Seifert, PharmD

Rhinitis: Putting the Problem Into Perspective - Dennis M. Williams, PharmD, FRCP

Optimal Approaches to Rhinitis Diagnosis and Management - Suman Golla, MD, FACS

Enhancing Patient Outcomes - Randall D. Seifert, PharmD

The Changing Landscape in Managed Care: Implications of OTC Products on Coverage - Andy Szczotka, PharmD

Questions and Answers

 

Instructions

To receive continuing education credit, you must view the web cast, take a post-test and complete a program evaluation. Upon successful completion, you will have access to print your statement of credit from the website.

1. Register online for Rhinitis: Clearing the way to better patient outcomes. You will need to log-in with your username and password. If this is your first time taking a course through Extension Services in Pharmacy you will need to create a new account.
2. Once registered, the course page will have links to the Web cast (six separate lectures). Listen to the lectures and view the corresponding slides. There will also be printable versions of the slides available on the course page.
3. After listening to the lectures, select Post-Test for Rhinitis. Complete on-line and submit answers. You must achieve a minimum score of 70% correct. In the event your score is below 70%, you will be provided with an option to “retake” the post-test by changing the previously recorded response(s).
4. Upon successful completion of the Post-Test, select “Evaluation of Rhinitis”. Complete and submit evaluation responses.
5. You will then be able to click on Rhinitis: Clearing the Way to Better Patient Outcomes Certificate, listed under "Statement of Credit", to view and print statement of credit.
6. For assistance, please contact Extension Services in Pharmacy by email or 608-890-0312.

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Continuing Education Credit

Extension Services in Pharmacy at the University of Wisconsin-Madison School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This program has been approved for a maximum of 2 hours (0.2 CEUs) of pharmacy continuing education credit. Statements of Credit will be mailed within 30 days of receipt of materials documenting participation in this program (verified participation as well as completion of a program evaluation). Universal Program #073-999-07-209-H01-P.

Release date: 1/18/2008
Expiration date: 1/18/2009

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