Influence of patient care provider on patient health outcomes in allergic rhinitis

Background: Diagnosing and managing the symptoms of allergic rhinitis are largely the responsibility of family physicians and allergists, but some patients choose self-management. However, few data are available to determine how the choice of care relates to measures of patient outcomes, such as the ability to perform activities, quality of life, and productivity. Objective:. To examine and compare patients' ability to perform activities, quality of life, productivity, and symptoms according to care provider: family physician, allergist, or self-management. Methods: A questionnaire was developed and mailed to 2,065 patients enrolled in a 500,000-member managed care organization. Patients were identified by diagnostic codes for allergic rhinitis as determined from a retrospective examination of medical and prescription claims records between January 1, 2000, and December 31, 2000. Results: chi(2) Tests revealed statistically significant differences for symptoms, family history, testing, immunotherapy, and test value among patient care providers. Multivariate analysis of variance revealed statistically significant differences for activities, symptoms, and quality of life among patient care providers. Findings support the use of diagnostic testing to improve patient outcomes. Symptoms were statistically significantly associated with measures of productivity. Conclusions: Patient outcomes vary with respect to patient care group. It is imperative that patients suspected of having allergic rhinitis undergo appropriate evaluation and testing. Outcomes can be optimized if allergists and family physicians have access to appropriate diagnostic tools, such as skin testing and serologic tests for specific IgE antibodies.