ABSTRACT
Allergic Rhinitis (AR) is a common global health problem with approximately one quarter
of the world population affected. The Quality of Life (QOL) of sufferers with AR is
significantly affected. The aim of this study was to evaluate the QOL of adults with AR. This
study was designed for adults with AR above 18 years old. The study was conducted using a
valid Rhinitis Quality of Life Questionnaires (RQLQ) which was completed for each patient
during clinic visit and analyzed by applying statistical methods. One-hundred and ten AR
patients participated in this study. Mean age of these patients was 32 years old and 62% were
female.
The correlation between severity of AR and QOL impairment was significant.
Frequencies of mild persistent, moderate-severe persistent, mild intermittent and moderatesevere
intermittent types of AR were 18%, 34.5%, 9% and 38%, respectively. Completed
RQLQ indicated that about 55% of the cases were suffering from severe disturbances in
their QOL. Furthermore, congestion (88%) was the most common symptom. The
correlation between congestion and QOL reduction was significant. The correlation between
congestion and sleep impairment was significant. AR was more common in young as well as
female patients and their QOL was affected more than the others. The results showed a
good relevancy between severity of symptoms and QOL scores.
Consisting with ARIA classification, it was found that reduction in the quality of life is
higher in patients with moderate-severe intermittent and persistent asthma. Nasal congestion
was a bothersome and prevalent symptom in AR that was responsible for sleep problems.
Therefore, nasal congestion was associated with sleep-disordered breathing, nocturnal sleep
impairment, day time fatigue and somnolence which finally lead to QOL impairment.
INTRODUCTION
Allergic rhinitis (AR) is a common global health
problem. About one fourth of the world populationsuffers from AR.1 The term rhinitis refers to a
heterogenous group of nasal disorders characterized by
one or more of the following symptom: Sneezing,
itching, nasal congestion and rhinorrhea. Rhinitis can
be caused by allergic, non-allergic, infectious,
hormonal, occupational and the other factors. AR is the
most common chronic rhinitis and the prevalence of
AR continues to increase. Severe AR has been
associated with diminished quality of life (QOL),
disordered sleep, obstructive sleep apnea and
impairment in work performance.2
Based on Allergic
Rhinitis and its Impact on Asthma (ARIA) guidelines,
3
one of the factors that reclassifies the severity of AR
from mild to moderate-severe is abnormal sleep. In
moderate to severe AR, there are abnormal sleep
(insomnia and nocturnal awakening), work productivity
deterioration and QOL disorder. Quality of life
signifies wellbeing and satisfaction of life; Health
Related Quality of life (HRQOL)4
refers to part of
QOL associated with health. Since measuring quality of
life requires proper instrument, in recent decades such
means have been developed in forms of specific
validated questionnaires.
These questionnaires used for determining the
severity of disease as well as assessing treatment
effects of various drugs on diseases.5-7.The
Rhinoconjunctivitis Quality of life Questionnaire
(RQLQ) about the quality of life of the patients
suffering from Rhinocojunctivitis was first prepared by
Juniper and Guyatt in 1991.8 Various studies were
performed to assess QOL of AR patients. For example,
Valero (2009) in spain9
found out that QOL of patients
who suffered from persistent AR was more
troublesome. According to Another comprehensive
study conducted in US,10 the incidence of AR, sleep
disorder and their impacts on daily activities of both
groups of adults and infants was significant. In Iran,
various studies have been conducted on AR in children
and adults. However, no study on QOL of AR patients
has been implemented.
The aim of this study was to evaluate quality of life
in Iranian adults affected by AR. The present study
through surveying QOL in adults suffering from
allergic rhinitis tried to recognize the problems that
adults with AR experience in their day to day lives. The
study used a valid RQLQ8
and assessed AR symptoms
adverse effects on nocturnal sleep, daily practice and
finally QOL in the AR patients. frequency of nasal congestion was 88.2%, rhinorrhea
85.5%, frequent sneezing 70.9% and eye itching
55.9%. Reliability and validity analysis were performed
using the SPSS 16 version statistical package. The
internal consistency of the RQLQ was tested by
Cronbach alpha scores. All correlation coefficients for
RQLQ were above 0.8. Finally, the QOL of the patients
to be studied based on the mean scores of the
questionnaires received was classifies into two groups
of mild (with mean value of the scores of QOL