TOPLINE

A digital decision-support tool, the Respiratory Allergy Optimiser, identified opportunities to optimise treatment among primary care patients in line with guideline recommendations.

METHODOLOGY

• Researchers conducted a pre-post interventional study across 11 general practices in Netherlands from August to November 2025, evaluating the Respiratory Allergy Optimiser, a digital decision-support tool for guideline-based management of allergic rhinitis.
• A total of 103 adult patients with rhinitis (99 with allergic rhinitis) were included (mean age, 49 years; 61% women); 91 patients completed follow-up assessments.
• The tool incorporated recommendations from three guidelines; assessed symptom severity using a visual analogue scale (VAS; range, 0-100 mm); and collected information on patient characteristics, symptoms, medication use, adherence, and nasal inhalation technique. 
• Treatment recommendations that were possible based on the guidelines were generated and included starting treatment, optimising management (adherence, technique, and avoidance of triggers), adjusting treatment levels, and considering allergen immunotherapy.
• Patients completed a survey after the visit and a follow-up survey 2 weeks later. The primary outcome was change in VAS symptom severity from baseline to follow-up.

TAKEAWAY

• Treatment step-up was the guideline-based recommendation in 41% of patients, medication continuation in 27%, and step-down in 17%.
• Among patients with uncontrolled allergic rhinitis at baseline (VAS > 50 mm; n = 31), mean VAS scores significantly decreased from 68.0 at baseline to 52.7 after 2 weeks (P < .001). Mean VAS scores in the overall population remained comparable between baseline and follow-up.
• Patients with the persistent allergic rhinitis phenotype had significantly higher mean VAS scores at baseline and follow-up (43.7 and 42.0, respectively) than those with the intermittent allergic rhinitis phenotype (22.6 and 26.9, respectively); however, the change in VAS scores over time did not differ significantly between phenotypes.
• Overall, 55% of the patients reported better consultation support with the Respiratory Allergy Optimiser than with standard consultations, and 63% of the patients indicated a future preference for allergy consultations using the Optimiser.

IN PRACTICE

"[The study] findings suggest that the Respiratory Allergy Optimiser has value as an implementation tool to identify treatment gaps and support guideline-directed management of allergic rhinitis in primary care," the authors of the study wrote.

SOURCE

The study was led by Iris van Geer-Postmus, PhD, of the General Practitioners Research Institute in Groningen, Netherlands. It was published online on August 22, 2026, in npj Primary Care Respiratory Medicine.

LIMITATIONS

The study's design without a concurrent control group limited causal inference. Study visits were conducted after peak pollen season (August to November 2025), potentially resulting in fewer patients with intermittent allergic rhinitis being included and fewer severe symptoms. The 2-week follow-up was insufficient to assess long-term symptom control, treatment persistence, or sustainability of treatment changes.

DISCLOSURES

This study was supported by an unrestricted grant from ALK-Abelló. Multiple authors reported being employed by the General Practitioners Research Institute, which conducted research funded by multiple pharmaceutical companies. Several authors reported receiving honoraria or speaker fees from various pharmaceutical companies or the General Practitioners Research Institute or serving on advisory boards for these organisations. One author reported holding shares in Lothar Medtec and being the owner of the General Practitioners Research Institute.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.