Catalytic Health

5 Special Supplement, May 2023 • Canadian Allergy & Immunology Today R E S U LT S Patient characteristics A total of 503 patients were enrolled in the study from sites comprising 91% primary care, 8% allergy, and 1% respiratory/sleep medicine. The mean participant age was 43.9 years and 52% of participants were women (Table 1). The majority of patients were uncontrolled (36%) or partially controlled (51%) at baseline; 20% were treatment-naïve; 32% were uncontrolled despite treatment, and 30% needed to switch treatment because of adverse effects (Table 1). The most common comorbidities were asthma (21%) and eczema/atopic dermatitis (20%). A total of 66% of patients were taking non-sedating antihistamines (34% OTC and 32% prescription) and 41% were taking nasal corticosteroids (Table 1). Patients reported having tried a median of three AR medications (Table 1). Overall, 78% of patients indicated that they were dissatisfied with their treatment in the previous month; 62% of patients were either "not satisfied" or "feel awful" at baseline with their current treatment (Figure 1). Treatment-naïve patients tended to rate at the extremes of treatment satisfaction vs the patients uncontrolled despite treatment or patients needing treatment switch with 15% reporting they were "very satisfied," yet 32% reporting they "feel awful" (Figure 1). Satisfaction with treatment was generally similar across comorbidities, although a slightly greater number of patients with urticaria or nasal polyps reported "not satisfied" or "feel awful" (Supplemental Figure S1). AR assessment at baseline At the baseline visit, patients reported that their most bothersome AR symptoms were congestion/ stuffed nose (68%), followed by sneezing (37%); runny nose (30%), itchy/watery eyes (23%); sore throat/ cough (11%); and sleep disturbance (8%). The overall average (SD) RCAT score was 16 (5.2) at baseline (Figure 2). Individual RCAT item scores indicated that patients frequently had nasal congestion and that AR symptoms had been poorly controlled in the previous week (Figure 2). Similar baseline RCAT results seen in the overall patient population were observed in the treatment-naïve patients (RCAT=17) and patients needing treatment switch (RCAT=17), whereas AR symptoms were higher in the patients who were uncontrolled despite treatment (RCAT=14; Supplemental Figure S2). Baseline RCAT was similar among patients with asthma (RCAT=16); eczema/ atopic dermatitis (RCAT=16); urticaria (RCAT=15); or no comorbidities (RCAT=16), and was numerically higher (i.e., fewer symptoms) for patients with nasal polyps (RCAT=18) (Figure 3 and Supplemental Figure S3). At baseline, the patient mean (SD) VAS score was 6.5 (2.4) and the clinician VAS score was 6.6 (2.2; Figure 4), indicating poorly controlled symptoms perceived by both patients and clinicians. Demographic or characteristic Patients, N=503 Female, n (%) 264 (52) Age, mean (SD), y 43.9 (17.5) Physician-assessed AR symptom control, n (%) Uncontrolled 179 (36) Partially controlled 259 (51) Controlled 40 (8) Missing data 25 (5) AR category, n (%) Treatment naïve 101 (20) Uncontrolled by current treatment 160 (32) Treatment switch needed due to AEs 149 (30) Not categorized 93 (18) Province, n (%) Ontario 325 (65) British-Columbia 141 (28) Quebec 35 (7) Alberta 2 (0.4) Comorbidities, n (%) None 199 (40) Asthma 105 (21) Eczema/atopic dermatitis 103 (20) Urticaria 27 (5) Nasal polyps 22 (4) Missing data 47 (9) Duration of AR symptoms, y Median (IQR) 5 (3-10) Range 0-46 Current treatments, n (%) Nasal corticosteroid 206 (41) Non-sedating OTC oral antihistamines 171 (34) Prescription oral antihistamines 161 (32) Nasal saline 55 (11) Sedating OTC oral antihistamines 20 (4) Nasal sprays 15 (3) Past treatments, n (%) Nasal corticosteroid 126 (25) Non-sedating OTC oral antihistamines 206 (41) Prescription oral antihistamines 75 (15) Nasal saline 91 (18) Sedating OTC oral antihistamines 150 (30) Nasal sprays 75 (15) Number of AR medications tried Median (IQR) 3 (2-6) Range 0-17 Table 1. Patient demographics and disease characteristics. AEs: adverse effects; AR: allergic rhinitis; IQR: interquartile range; OTC: over-the-counter.

• Cover