Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study

Background: Allergic rhinitis (AR) and chronic urticaria impose significant socioeconomic burdens on lower-income countries. Despite the availability of evidence-based guidelines, their implementation varies, and comprehensive data on these allergic conditions are notably lacking in Thailand. Object...

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Main Authors: Hiroshi Chantaphakul, MD, Chirawat Chiewchalermsri, MD, Dara Mairiang, MD, Mongkol Lao-Araya, MD, Orathai Piboonpocanun, MD, Sira Nanthapisal, MD, PhD, Wat Mitthamsiri, MD, Wasu Kamchaisatian, MD, Wiparat Manuyakorn, MD, PhD, Pasuree Sangsupawanich, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Journal of Allergy and Clinical Immunology: Global
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772829325000451
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author Hiroshi Chantaphakul, MD
Chirawat Chiewchalermsri, MD
Dara Mairiang, MD
Mongkol Lao-Araya, MD
Orathai Piboonpocanun, MD
Sira Nanthapisal, MD, PhD
Wat Mitthamsiri, MD
Wasu Kamchaisatian, MD
Wiparat Manuyakorn, MD, PhD
Pasuree Sangsupawanich, MD, PhD
author_facet Hiroshi Chantaphakul, MD
Chirawat Chiewchalermsri, MD
Dara Mairiang, MD
Mongkol Lao-Araya, MD
Orathai Piboonpocanun, MD
Sira Nanthapisal, MD, PhD
Wat Mitthamsiri, MD
Wasu Kamchaisatian, MD
Wiparat Manuyakorn, MD, PhD
Pasuree Sangsupawanich, MD, PhD
author_sort Hiroshi Chantaphakul, MD
collection DOAJ
description Background: Allergic rhinitis (AR) and chronic urticaria impose significant socioeconomic burdens on lower-income countries. Despite the availability of evidence-based guidelines, their implementation varies, and comprehensive data on these allergic conditions are notably lacking in Thailand. Objectives: We sought to describe current management strategies for AR and urticaria in Thailand. Methods: The Allergy, Asthma, and Immunology Association of Thailand used a modified Delphi method to explore consensus on management strategies for AR and urticaria. Clinicians with expertise in these conditions provided input through a web-based questionnaire. The survey assessed disease burden in Thailand, its impact on quality of life, and the use of H1-antihistimine treatment options. Results: In total, 105 experts, mainly in allergy and immunology, with 70% having more than 10 years of clinical practice, provided input. Consensus was achieved on 22 (88%) of the 25 statements. Second-generation antihistamines were preferred as initial treatment for AR and urticaria because of their reduced sedation and lack of anticholinergic effects. Almost all participants (98.1%) recommended these antihistamines for acute and chronic urticaria. Additionally, 87.6% of the respondents favored up-dosing a single antihistamine agent for managing chronic urticaria. The benefits of orally disintegrating antihistamines were particularly noted for their ease of administration and patient compliance. Conclusion: Results indicate a knowledge gap in evidence-based practices among Thai clinicians. Addressing this gap through enhancing clinical guideline adherence and encouraging pharmacist involvement in patient care can improve access to medication and better disease management, ultimately improving patient outcomes while reducing the socioeconomic burden of AR and urticaria.
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spelling doaj-art-02ecd59f699e42dd888d9ab48d40a4d42025-08-20T03:09:12ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932025-05-014210044410.1016/j.jacig.2025.100444Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi studyHiroshi Chantaphakul, MD0Chirawat Chiewchalermsri, MD1Dara Mairiang, MD2Mongkol Lao-Araya, MD3Orathai Piboonpocanun, MD4Sira Nanthapisal, MD, PhD5Wat Mitthamsiri, MD6Wasu Kamchaisatian, MD7Wiparat Manuyakorn, MD, PhD8Pasuree Sangsupawanich, MD, PhD9Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Medicine, King Chulalongkorn Memorial Hospital / The Thai Red Cross Society, Bangkok, Thailand; Corresponding author: Hiroshi Chantaphakul, MD, Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Department of Medicine, King Chulalongkorn Memorial Hospital / The Thai Redcross Society, Bangkok, Thailand.Department of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, ThailandDepartment of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDivision of Allergy and Clinical Immunology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Pediatrics and Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Allergy, Immunology, and Rheumatology, Thammasat University, Pathumthani, ThailandAllergy and Clinical Immunology Division, Department of Medicine, Phramongkutklao Hospital, Bangkok, ThailandPediatric Allergy and Immunology Division, Samitivej Children’s Hospital, Bangkok, ThailandDivision of Allergy, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDivision of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, ThailandBackground: Allergic rhinitis (AR) and chronic urticaria impose significant socioeconomic burdens on lower-income countries. Despite the availability of evidence-based guidelines, their implementation varies, and comprehensive data on these allergic conditions are notably lacking in Thailand. Objectives: We sought to describe current management strategies for AR and urticaria in Thailand. Methods: The Allergy, Asthma, and Immunology Association of Thailand used a modified Delphi method to explore consensus on management strategies for AR and urticaria. Clinicians with expertise in these conditions provided input through a web-based questionnaire. The survey assessed disease burden in Thailand, its impact on quality of life, and the use of H1-antihistimine treatment options. Results: In total, 105 experts, mainly in allergy and immunology, with 70% having more than 10 years of clinical practice, provided input. Consensus was achieved on 22 (88%) of the 25 statements. Second-generation antihistamines were preferred as initial treatment for AR and urticaria because of their reduced sedation and lack of anticholinergic effects. Almost all participants (98.1%) recommended these antihistamines for acute and chronic urticaria. Additionally, 87.6% of the respondents favored up-dosing a single antihistamine agent for managing chronic urticaria. The benefits of orally disintegrating antihistamines were particularly noted for their ease of administration and patient compliance. Conclusion: Results indicate a knowledge gap in evidence-based practices among Thai clinicians. Addressing this gap through enhancing clinical guideline adherence and encouraging pharmacist involvement in patient care can improve access to medication and better disease management, ultimately improving patient outcomes while reducing the socioeconomic burden of AR and urticaria.http://www.sciencedirect.com/science/article/pii/S2772829325000451Allergic rhinitisantihistaminesDelphi methodurticaria
spellingShingle Hiroshi Chantaphakul, MD
Chirawat Chiewchalermsri, MD
Dara Mairiang, MD
Mongkol Lao-Araya, MD
Orathai Piboonpocanun, MD
Sira Nanthapisal, MD, PhD
Wat Mitthamsiri, MD
Wasu Kamchaisatian, MD
Wiparat Manuyakorn, MD, PhD
Pasuree Sangsupawanich, MD, PhD
Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study
Journal of Allergy and Clinical Immunology: Global
Allergic rhinitis
antihistamines
Delphi method
urticaria
title Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study
title_full Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study
title_fullStr Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study
title_full_unstemmed Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study
title_short Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study
title_sort allergic rhinitis and urticaria burden and antihistamine treatment options in thailand a modified delphi study
topic Allergic rhinitis
antihistamines
Delphi method
urticaria
url http://www.sciencedirect.com/science/article/pii/S2772829325000451
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