Allergies
Jen Hand
A pharmacist-led education intervention eased allergic rhinitis symptoms when compared with standard care over 180 days, a recent study revealed. However, researchers observed no significant differences between the intervention group and the standard care group for other outcomes, including knowledge level, medication adherence, or quality of life (QOL).
“These findings suggest that while pharmacist-led education can enhance symptom management, additional strategies may be needed to address broader aspects of [allergic rhinitis] care,” wrote Chew and colleagues in a paper published July 16, 2025, in JAMA Network Open.
Allergic rhinitis affects between 10% and 30% of the population, according to the World Allergy Organization. The condition is caused by IgE-mediated inflammation of the nasal mucosa and is a risk factor for asthma. Allergic rhinitis management is typically based on pharmacotherapy, immunotherapy, environmental control measures, and patient education on allergen avoidance.
Study design and results
Investigators recruited 209 adult patients with a diagnosis of allergic rhinitis for the parallel-group, open-label clinical trial conducted in the otorhinolaryngology outpatient clinic at a government-funded tertiary hospital in northern Malaysia. Among the eventual 154 study participants, the mean age was 46.5 years, and 63% were women. Seventy-seven participants were randomized to the intervention group, and 77 to the control (standard care) group.
The research team developed the pharmacist-led education intervention (AR-PRISE) model, which integrated audiovisual patient education and systematic counseling. According to the study authors, the model provides a structured framework for allergic rhinitis management in public health care services by shifting from physician-centric care to a collaborative approach that leverages pharmacists’ medication expertise.
The intervention group watched an 8-minute educational video on allergic rhinitis. They also received pharmacist counseling that included assessment of symptoms and QOL, treatment goals and concerns, intranasal corticosteroid administration techniques, and nonadherence consequences. Both groups received a diary booklet for documenting medication use (which for the intervention group had a QR code intended to provide at-home access to the video).
Those in the control group received standard care, including physician consultations and routine medication counseling at the outpatient pharmacy but no additional interventions or access to educational resources.
The primary outcomes were between-group differences at day 180 in allergic rhinitis knowledge level, symptom control using the Total Nasal Symptom Score (TNSS) for the past 12 hours and past 2 weeks; medication adherence (the number of days on intranasal corticosteroid use); and QOL (using the European Quality of Life 5-Dimension 5-Level Instrument and European Quality of Life Visual Analog Scale). All outcomes, except knowledge level, were measured at baseline and days 60, 120, and 180.
In the AR-PRISE group, study results showed the one outcome with statistically significant improvements was the TNSS for the past 2 weeks compared with controls. The authors said, “No significant differences were observed for knowledge level, TNSS for the past 12 hours, medication adherence, or quality of life” between the groups in coprimary outcomes.
The researchers also acknowledged limitations, including how the single-center design and exclusion of non-English or Malay speakers could limit generalizability. However, the cohort’s racial and ethnic distribution aligned with national demographics.
Discussion
“The AR-PRISE intervention showed a stronger treatment effect observed in the TNSS for the past 2 weeks (sustained control) versus the TNSS for the past 12 hours (immediate symptoms), reflecting its focus on long-term disease management,” study authors wrote. “Nevertheless, because potential waning effects or behavioral drift cannot be ruled out, its long-term sustainability remains uncertain.”
Depending on symptoms, allergic rhinitis can impact patients psychologically, socially, and economically. The researchers noted the vital role pharmacists play in allergic rhinitis management through patient education, pharmacologic recommendations, and self-management support.
“By leveraging pharmacists’ accessibility and expertise, this model promotes a team-based approach to [allergic rhinitis] management,” said the authors. ■