Summary NR 509 Allergic rhinitis CPG Clinical Practice Guideline: Allergic Rhinitis

NR 509 Allergic rhinitis CPG Clinical Practice Guideline: Allergic Rhinitis Michael D. Seidman, MD1, Richard K. Gurgel, MD2, Sandra Y. Lin, MD3, Seth R. Schwartz, MD, MPH4, Fuad M. Baroody, MD5, James R. Bonner, MD6, Douglas E. Dawson, MD7, Mark S. Dykewicz, MD8, Jesse M. Hackell, MD9, Joseph K. Han, MD10, Otolaryngology– Head and Neck Surgery 2015, Vol. 152(1S) S1–S43 © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014 Reprints and permission: Stacey L. Ishman, MD, MPH11, Helene J. Krouse, PhD, ANP-BC, CORLN12, Sonya Malekzadeh, MD13, James (Whit) W. Mims, MD14, Folashade S. Omole, MD15,William D. Reddy, LAc, DiplAc16, Dana V.Wallace, MD17, Sandra A.Walsh18, Barbara E.Warren, PsyD, MEd18, Meghan N.Wilson, MD19, and Lorraine C. Nnacheta, MPH20 Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Abstract Objective. Allergic rhinitis (AR) is one of the most common diseases affecting adults. It is the most common chronic dis- ease in children in the United States today and the fifth most common chronic disease in the United States overall. AR is estimated to affect nearly 1 in every 6 Americans and gener- ates $2 to $5 billion in direct health expenditures annually. It can impair quality of life and, through loss of work and school attendance, is responsible for as much as $2 to $4 billion in lost productivity annually. Not surprisingly, myriad diagnos- tic tests and treatments are used in managing this disorder, yet there is considerable variation in their use. This clinical practice guideline was undertaken to optimize the care of patients with AR by addressing quality improvement opportu- nities through an evaluation of the available evidence and an assessment of the harm-benefit balance of various diagnostic and management options. Purpose. The primary purpose of this guideline is to address quality improvement opportunities for all clinicians, in any set- ting, who are likely to manage patients with AR as well as to optimize patient care, promote effective diagnosis and thera- py, and reduce harmful or unnecessary variations in care. The guideline is intended to be applicable for both pediatric and adult patients with AR. Children under the age of 2 years were excluded from the clinical practice guideline because rhinitis in this population may be different than in older patients and is not informed by the same evidence base. The guideline is