Visual analogue scale in patients treated for allergic rhinitis: an observational prospective study in primary care

<jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Allergic rhinitis (<jats:styled-content style="fixed-case">AR</jats:styled-content>) severity is evaluated using scores such as Rhinoconjunctivitis Quality‐of‐Life Questionnaire (<jats:styled-content style="fixed-case">RQLQ</jats:styled-content>) and total symptom score (<jats:styled-content style="fixed-case">TSS</jats:styled-content>). However, a simple assessment is needed to enable physicians to evaluate the severity of the <jats:styled-content style="fixed-case">AR</jats:styled-content> and the efficacy of the treatment.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>The main objective was to validate visual analogue scale (<jats:styled-content style="fixed-case">VAS</jats:styled-content>) as a simple quantitative tool to assess the burden of <jats:styled-content style="fixed-case">AR</jats:styled-content> in primary care.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The study was multi‐centre prospective observational conducted in patients consulting general practitioners for symptomatic rhinitis. <jats:styled-content style="fixed-case">VAS</jats:styled-content>,<jats:styled-content style="fixed-case"> RQLQ</jats:styled-content> and <jats:styled-content style="fixed-case">TSS</jats:styled-content>6 were assessed at the consultation day and 14 days later, and changes were analysed using paired test. Correlations between <jats:styled-content style="fixed-case">VAS</jats:styled-content>,<jats:styled-content style="fixed-case"> RQLQ</jats:styled-content> and <jats:styled-content style="fixed-case">TSS</jats:styled-content>6 were assessed. Cut‐off levels for <jats:styled-content style="fixed-case">VAS</jats:styled-content>, which discriminate significant from insignificant changes, were established using Receiver Operating Characteristic curves.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 990 patients were included in the study. According to allergic rhinitis and its impact on asthma classification, mild intermittent rhinitis was diagnosed in 20% patients, mild persistent in 17%, moderate/severe intermittent in 15% and moderate/severe persistent in 48%, at the consultation day. At day‐14, rhinitis symptoms and QoL improved significantly in almost all patients. Impairment incurred by <jats:styled-content style="fixed-case">AR</jats:styled-content> and assessed with <jats:styled-content style="fixed-case">VAS</jats:styled-content> improved also. The established cut‐off variation of 23 mm for <jats:styled-content style="fixed-case">VAS</jats:styled-content> was associated with a cut‐off variation of 0.5 for <jats:styled-content style="fixed-case">RQLQ</jats:styled-content>. Sensitivity analysis with <jats:styled-content style="fixed-case">RQLQ</jats:styled-content> and <jats:styled-content style="fixed-case">TSS</jats:styled-content>6 scales confirmed the aptitude of the cut‐off value (23 mm) to discriminate changes in symptoms and QoL.</jats:p></jats:sec><jats:sec><jats:title>Conclusion and Clinical Relevance</jats:title><jats:p>The <jats:styled-content style="fixed-case">VAS</jats:styled-content> can detect with high sensitivity the variations of symptoms and QoL in patients with <jats:styled-content style="fixed-case">AR</jats:styled-content>.</jats:p></jats:sec>