Respiratory allergy questionare can help for diagnosis

Allergic rhinitis (AR) is the most frequent immune-mediated disorder, and its prevalence is still increasing worldwide, as recently underlined in the Gene Environment Interactions in Respiratory Diseases (GEIRD) epidemiological study . AR is defined as a symptomatic disorder of the nasal mucosa, due to an IgE-mediated reaction that follows the immediate contact with an offending allergen. The major symptoms of AR are nasal itching, sneezing, rhinorrhea and obstruction, that are spontaneously reversible or may be controlled by adequate treatment . AR may also be part of the Severe Chronic Upper Airways Disease (SCUAD)  and is frequently associated with comorbidities such as rhinosinusitis, asthma, conjunctivitis, nasal polyposis, and sleep disturbances, which make the diagnostic approach more complex . Nevertheless, AR is still often considered as a “trivial” disease, that can be easily manageable by the patient himself or by healthcare providers other than physicians. Instead, its health and social impact is substantial, considering the costs, either direct (expenditure for drugs, access to medical care) or indirect (absenteeism, presenteism, decreased school/work performance) . Finally, AR is frequently associated with asthma but, more importantly, it represents the more relevant independent risk factor for asthma onset . In this complex context, primary care physicians and also pharmacists are usually the first-line referral for AR patients, but thus far there is no easy, simple and self-administered test to be used in the primary care physician setting to discriminate a suspicion of AR, so that the patient can be subsequently referred to the allergist for a more detailed or confirmatory diagnosis by skin prick test (SPT), in vitro IgE assay, specific provocation test or molecular-based diagnosis.