Adherence of doctors to clinical recommendations in the management of children and adolescents with allergic rhinitis

Introduction. The Russian Federation has adopted international and national conciliatory documents and clinical guidelines covering the diagnosis and treatment of allergic rhinitis (AR). The extent to which doctors adhere to the guidelines remains unclear.Methods: online survey of allergists (32.7%)...

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Main Authors: Yu. S. Smolkin, S. S. Masalskiy, N. V. Shakhova, A. N. Molochkova
Format: Article
Language:Russian
Published: Association of Paediatric Allergists and Immunologists of Russia (APAIR) 2025-06-01
Series:Аллергология и Иммунология в Педиатрии
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Online Access:https://adair.elpub.ru/jour/article/view/192
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author Yu. S. Smolkin
S. S. Masalskiy
N. V. Shakhova
A. N. Molochkova
author_facet Yu. S. Smolkin
S. S. Masalskiy
N. V. Shakhova
A. N. Molochkova
author_sort Yu. S. Smolkin
collection DOAJ
description Introduction. The Russian Federation has adopted international and national conciliatory documents and clinical guidelines covering the diagnosis and treatment of allergic rhinitis (AR). The extent to which doctors adhere to the guidelines remains unclear.Methods: online survey of allergists (32.7%), pediatricians (54.4%) and others (total n = 364) in 2023–2024.Results: Most specialists (81.6%) adhere to Russian official clinical recommendation, while about 4% of respondents adhere to international guidelines. A significant part of doctors actively uses the term “seasonal/perennial” AR (75.3%), less often the indication of the severity and course of the disease is used. Pediatricians don’t use the classification more often than allergists. To determine the severity of the visual analog scale is used only in 23.0% of cases.Among laboratory diagnostic methods, allergists are more likely to prescribe a specific examination than pediatricians (87.8% vs. 56.8%). Only 53.8% of respondents consider it mandatory to conduct an allergological examination for patients with AR.57.4% of respondents believe that the amount of initial therapy depends on the severity of the disease. The most popular drugs for starting therapy are intranasal steroids (40.2%), antihistamines (23.5%), montelukast 4.0%, and intranasal antihistamines 4,8%. If it is necessary to use concomitant therapy 56.4% of doctors choose a fixed combination of intranasal steroid + antihistamines as a first-line therapy, and an additional 20.9% consider this option in rare cases. In severe cases, 16.9% of doctors prescribe oral steroids, 20.4% choose the parenteral route of corticosteroid administration, and 33.6% of respondents do not prescribe systemic corticosteroids. The majority of doctors surveyed are aware of the immunobiological therapy of AR — 73.0%, and 26.7% actively support the appointment of biological therapy for AR. Allergen-specific therapy is recommended to be considered by 61.9% of the surveyed doctors.Conclusion: The study shows the need to train physicians facing AR problems in accordance with current clinical guidelines and international practice.
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spelling doaj-art-cb6b71b2d5d347e7b388f2ddfd7a4f7f2025-08-20T03:42:34ZrusAssociation of Paediatric Allergists and Immunologists of Russia (APAIR)Аллергология и Иммунология в Педиатрии2500-11752712-79582025-06-010152010.53529/2500-1175-2025-1-5-20132Adherence of doctors to clinical recommendations in the management of children and adolescents with allergic rhinitisYu. S. Smolkin0S. S. Masalskiy1N. V. Shakhova2A. N. Molochkova3Scientific-Clinical Consultative Center of Allergology and Immunology ; Academy of Postgraduate Education of the Federal State Budgetary Institution Federal Scientific and Practical Center of the Federal Medical and Biological Agency of RussiaMoscow Medical University “Reaviz” ; Scientific-Clinical Consultative Center of Allergology and ImmunologyFSBEI HE ASMU MOH RussiaScientific-Clinical Consultative Center of Allergology and ImmunologyIntroduction. The Russian Federation has adopted international and national conciliatory documents and clinical guidelines covering the diagnosis and treatment of allergic rhinitis (AR). The extent to which doctors adhere to the guidelines remains unclear.Methods: online survey of allergists (32.7%), pediatricians (54.4%) and others (total n = 364) in 2023–2024.Results: Most specialists (81.6%) adhere to Russian official clinical recommendation, while about 4% of respondents adhere to international guidelines. A significant part of doctors actively uses the term “seasonal/perennial” AR (75.3%), less often the indication of the severity and course of the disease is used. Pediatricians don’t use the classification more often than allergists. To determine the severity of the visual analog scale is used only in 23.0% of cases.Among laboratory diagnostic methods, allergists are more likely to prescribe a specific examination than pediatricians (87.8% vs. 56.8%). Only 53.8% of respondents consider it mandatory to conduct an allergological examination for patients with AR.57.4% of respondents believe that the amount of initial therapy depends on the severity of the disease. The most popular drugs for starting therapy are intranasal steroids (40.2%), antihistamines (23.5%), montelukast 4.0%, and intranasal antihistamines 4,8%. If it is necessary to use concomitant therapy 56.4% of doctors choose a fixed combination of intranasal steroid + antihistamines as a first-line therapy, and an additional 20.9% consider this option in rare cases. In severe cases, 16.9% of doctors prescribe oral steroids, 20.4% choose the parenteral route of corticosteroid administration, and 33.6% of respondents do not prescribe systemic corticosteroids. The majority of doctors surveyed are aware of the immunobiological therapy of AR — 73.0%, and 26.7% actively support the appointment of biological therapy for AR. Allergen-specific therapy is recommended to be considered by 61.9% of the surveyed doctors.Conclusion: The study shows the need to train physicians facing AR problems in accordance with current clinical guidelines and international practice.https://adair.elpub.ru/jour/article/view/192allergic rhinitischildrenadolescentsdoctors
spellingShingle Yu. S. Smolkin
S. S. Masalskiy
N. V. Shakhova
A. N. Molochkova
Adherence of doctors to clinical recommendations in the management of children and adolescents with allergic rhinitis
Аллергология и Иммунология в Педиатрии
allergic rhinitis
children
adolescents
doctors
title Adherence of doctors to clinical recommendations in the management of children and adolescents with allergic rhinitis
title_full Adherence of doctors to clinical recommendations in the management of children and adolescents with allergic rhinitis
title_fullStr Adherence of doctors to clinical recommendations in the management of children and adolescents with allergic rhinitis
title_full_unstemmed Adherence of doctors to clinical recommendations in the management of children and adolescents with allergic rhinitis
title_short Adherence of doctors to clinical recommendations in the management of children and adolescents with allergic rhinitis
title_sort adherence of doctors to clinical recommendations in the management of children and adolescents with allergic rhinitis
topic allergic rhinitis
children
adolescents
doctors
url https://adair.elpub.ru/jour/article/view/192
work_keys_str_mv AT yussmolkin adherenceofdoctorstoclinicalrecommendationsinthemanagementofchildrenandadolescentswithallergicrhinitis
AT ssmasalskiy adherenceofdoctorstoclinicalrecommendationsinthemanagementofchildrenandadolescentswithallergicrhinitis
AT nvshakhova adherenceofdoctorstoclinicalrecommendationsinthemanagementofchildrenandadolescentswithallergicrhinitis
AT anmolochkova adherenceofdoctorstoclinicalrecommendationsinthemanagementofchildrenandadolescentswithallergicrhinitis