Use of Diary for Allergic Rhinitis

Allergic rhinitis is one of the common diseases faced in an ENT clinic. Allergic rhinitis is a common inflammatory disorder which affects the nasal membranes and is characterized by symptoms such as sneezing and nasal congestion. It is a global health problem which affects approximately 500 million people worldwide.[1] With the increase in pollution, diseases such as allergic rhinitis are on the rise. Many times, asthma and allergic conjunctivitis are associated with allergic rhinitis. Allergic rhinitis is of two types: seasonal and perennial. The management of allergic rhinitis consists of prevention, pharmacotherapy, and immunotherapy. The problem associated with allergic rhinitis is recurrence. In some patients, the symptoms are so frequent and severe that it affects their work and lifestyle and causes sleep disturbances. Many times, patients complain that on discontinuation of medications, symptoms reappear. In some cases, there is overuse of medications in treating allergic rhinitis. It is also difficult to identify a specific allergen for patients in an ENT setup. Furthermore, it is difficult to completely cure allergic rhinitis although the symptoms can be controlled. In some countries, researchers have come up with a novel concept of allergy diary. The mobile app called allergy diary contains information on symptom type, duration (intermittent/persistent), disease impact, and medications used for allergic rhinitis. Users assessed symptom control using the Visual Analog Scale. The allergy diary integrates with updated ARIA guideline and allows better management of allergic rhinitis.[2] This allergy mobile app is also known as e-diary. They are questionnaires filled up by the patient daily usually on a mobile phone or tablet computer.[3-6] Advantages include an easy and quick process with the software automatically providing daily scores, time, trajectory, and descriptive reports.[7-10] In Europe, such diaries are available for pollen allergies and have been used in trials or observation studies.[7,9,11-14] In the E –diary approach investigation is done on the link of pollen exposure with Seasonal allergic rhino-conjunctivitis (SAR) severity in a prospective, rather than retrospective fashion.[3,15] The patients are given instructions to daily record their symptoms and intake of medications and the trajectory of their disease severity score is matched with the pollen concentrations of locally relevant allergenic pollens.[3,7] This prospective approach of e diaries has several advantages over retrospective approaches such as the absence of recall bias, time unit used is a single day instead of months, symptoms are graduated in a continuous fashion.[3] This concept of allergy diary being experimented by researchers in some countries is an important progressive encouraging step in the management of allergic rhinitis. Although the amount of research done till date is scanty, more research should be done on this topic for better management of allergic rhinitis. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.