Patient perspectives of allergic rhinitis and allergen immunotherapy: a qualitative study

Background: Allergic rhinitis (AR) is a highly prevalent condition associated with significant morbidity globally. Few recent studies have detailed the experiences of sufferers and explored their perspectives of treatment options. Allergen immunotherapy (AIT) is an effective treatment option that remains underused in eligible patient populations. Objective: We sought to describe patient perspectives of AR and treatment options including AIT. Methods: Twenty-five semistructured interviews were conducted with adult participants at a tertiary hospital center in Sydney, Australia. Authors used an inductive thematic analysis methodology to code and interpret the data. Results: Three major themes emerged from the qualitative thematic analysis: (1) a prolonged journey with symptoms, (2) multiple trials of therapy with incomplete symptom control, and (3) diverse experiences with AIT. Several subthemes were identified: (1) delays to diagnosis and management, (2) underestimating the impact of symptoms, (3) substantially impaired quality of life, (4) limited efficacy of symptomatic pharmacotherapy, (5) perceptions of tolerance and dependence, (6) motivations to access AIT, (7) diverse expectations of AIT, and (8) barriers to AIT access. Conclusions: Sufferers of AR experience an impactful symptom journey, with many achieving inadequate disease control despite symptomatic pharmacotherapy. The uptake of AIT is constrained by direct medication costs, insufficient public awareness, and limited prescriber availability. The findings of this study offer insights for health care professionals and policymakers to formulate strategies to enhance AR management and improve AIT access for eligible patients.