Knowledge and treatment preferences of family physicians regarding allergic rhinitis in primary care: A cross-sectional study from Denizli
Objective: This study aimed to evaluate the knowledge and treatment preferences of family physicians working in primary care in Denizli regarding the management of allergic rhinitis.
Materiels and Methods: This descriptive cross-sectional study was conducted between January 1 and July 31, 2023. The target population comprised all 337 family physicians working in Family Health Centers in the city center of Denizli. Data were collected using an electronic questionnaire developed by the researcher based on the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. Knowledge was assessed on an item-by-item basis.
Results: A total of 98 physicians returned the questionnaire (response rate: 29.1%). After excluding 13 questionnaires with incomplete core data, 85 physicians were included in the final analysis. Among the principal symptoms of allergic rhinitis, nasal obstruction was the least frequently recognized (72.9%). Only 27.1% of participants reported awareness of the ARIA guidelines. The most frequently preferred treatment for both intermittent and persistent rhinitis was a combination of an oral antihistamine and an intranasal corticosteroid. Item-level analyses demonstrated no significant association between age or professional experience and knowledge scores after correction for multiple comparisons
Conclusion: Participating family physicians recognized the main symptoms of allergic rhinitis at high rates and generally reported detailed history-taking practice. However, overall awareness of allergic rhinitis guidelines was low. Furthermore, deficiencies were identified regarding disease classification, severity assessment, and treatment management.
Key Words: Allergic rhinitis, family physicians, primary health care, health knowledge.
References
Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017;140(4):950-8. doi:10.1016/j.jaci.2017.03.050
2. Turkish National Society of Allergy and Clinical Immunology. Alerjik Rinit Tanı ve Tedavi Rehberi 2022 [Allergic Rhinitis Diagnosis and Treatment Guideline 2022]. Ankara: Turkish National Society of Allergy and Clinical Immunology, 2022. Available from: https://www.aid.org.tr/wp-content/uploads/2022/11/Alerjik-Rinit-Tani-ve-Tedavi-Rehberi-2022-web-vers4.pdf on 08/07/2026.
3. Wise SK, Damask C, Roland LT, Ebert C, Levy JM, Lin S, et al. International consensus statement on allergy and rhinology: Allergic rhinitis. Int Forum Allergy Rhinol. 2023;13(4):293–859. doi:10.1002/alr.23090.
4. Klimek L, Mullol J, Ellis AK, Izquierdo-Domínguez A, Hagemann J, Casper I, et al. Current management of allergic rhinitis. J Allergy Clin Immunol Pract. 2024;12(6):1399-412. doi:10.1016/j.jaip.2024.03.023.
5. Almousa H, Alsaad SM, Ismail D, Mahjoub S, Bin Obaid S, Alsaleh S. Allergic rhinitis guidelines knowledge, attitudes, and practices among primary health care physicians: A national multicentre cross-sectional study. J Family Med Prim Care. 2023;12(6):1202-8. doi:10.4103/jfmpc.jfmpc_85_23.
6. Balotro-Torres MCV, Tan FM, Navarro-Locsin CG, Recto MT, Romualdez JA, Ramos JB, et al. Real-world physician practices on the diagnosis and management of allergic rhinitis in the Philippine setting. Asia Pac Allergy. 2023;13(3):105–13. doi:10.5415/apallergy.0000000000000112.
7. Cabrera M, Ryan D, Erlewyn-Lajeunesse M, Levin M, Morais-Almeida M, Tanno LK, et al. Global assessment of the knowledge and confidence in managing allergic disorders among primary care pediatricians across Europe: An EAACI task force report. Pediatr Allergy Immunol. 2024;35(4):e14116. doi:10.1111/pai.14116.
8. Sousa-Pinto B, Bousquet J, Vieira RJ, Schünemann HJ, Zuberbier T, Bognanni A, et al. Allergic rhinitis and its impact on asthma (ARIA). EAACI Guidelines 2024–2025 Revision: Part I – Guidelines on Intranasal Treatments. Allergy. 2026;81(4):954–76. doi:10.1111/all.70131.
9. Nolte H, Nepper-Christensen S, Backer V. Unawareness and undertreatment of asthma and allergic rhinitis in a general population. Respir Med. 2006;100(2):354–62. doi:10.1016/j.rmed.2005.05.012.
10. Spinozzi F, Murgia N, Baldacci S, Maio S, Pala A, Casciari C, et al. Characteristics and predictors of allergic rhinitis undertreatment in primary care. Int J Immunopathol Pharmacol.2016;29(1):129–36. doi:10.1177/0394632015595779.
11. Van Hoecke H, Vandeplas G, Acke F, Thas O, De Sutter A, Gevaert P, et al. Dissemination and implementation of the ARIA guidelines for allergic rhinitis in general practice. Int Arch Allergy Immunol. 2014;163(2):106–13. doi:10.1159/000355953.
12. Urrutia-Pereira M, Fernandez C, Valentin-Rostan M, Cruz Á, Torres O, Simon L, et al. Conocimiento de médicos de atención primaria sobre Rinitis Alérgica y su Impacto en el Asma (ARIA): estudio piloto comparativo Brasil, Paraguay, Uruguay. Rev Alerg Mex. 2018;65(4):321-30. doi:10.29262/ram.v65i4.525.
13. Civelek E, Soyer OU, Gemicioğlu B, Şekerel BE. Turkish physicians’ perception of allergic rhinitis and its impact on asthma. Allergy. 2006;61(12):1454-8. doi:10.1111/j.1398-9995.2006.01214.
