Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study
Issued Date
2025-05-01
Resource Type
eISSN
27728293
Scopus ID
2-s2.0-105000132256
Journal Title
Journal of Allergy and Clinical Immunology: Global
Volume
4
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Allergy and Clinical Immunology: Global Vol.4 No.2 (2025)
Suggested Citation
Chantaphakul H., Chiewchalermsri C., Mairiang D., Lao-Araya M., Piboonpocanun O., Nanthapisal S., Mitthamsiri W., Kamchaisatian W., Manuyakorn W., Sangsupawanich P. Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study. Journal of Allergy and Clinical Immunology: Global Vol.4 No.2 (2025). doi:10.1016/j.jacig.2025.100444 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/108516
Title
Allergic rhinitis and urticaria burden and antihistamine treatment options in Thailand: A modified Delphi study
Author's Affiliation
Ramathibodi Hospital
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Faculty of Medicine, Khon Kaen University
Faculty of Medicine, Prince of Songkla University
Bangkok Children's Hospital
King Chulalongkorn Memorial Hospital
Thammasat University
Phramongkutklao College of Medicine
Faculty of Medicine, Chulalongkorn University
Srinakharinwirot University
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Faculty of Medicine, Khon Kaen University
Faculty of Medicine, Prince of Songkla University
Bangkok Children's Hospital
King Chulalongkorn Memorial Hospital
Thammasat University
Phramongkutklao College of Medicine
Faculty of Medicine, Chulalongkorn University
Srinakharinwirot University
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Allergic rhinitis (AR) and chronic urticaria impose significant socioeconomic burdens on lower-income countries. Despite the availability of evidence-based guidelines, their implementation varies, and comprehensive data on these allergic conditions are notably lacking in Thailand. Objectives: We sought to describe current management strategies for AR and urticaria in Thailand. Methods: The Allergy, Asthma, and Immunology Association of Thailand used a modified Delphi method to explore consensus on management strategies for AR and urticaria. Clinicians with expertise in these conditions provided input through a web-based questionnaire. The survey assessed disease burden in Thailand, its impact on quality of life, and the use of H1-antihistimine treatment options. Results: In total, 105 experts, mainly in allergy and immunology, with 70% having more than 10 years of clinical practice, provided input. Consensus was achieved on 22 (88%) of the 25 statements. Second-generation antihistamines were preferred as initial treatment for AR and urticaria because of their reduced sedation and lack of anticholinergic effects. Almost all participants (98.1%) recommended these antihistamines for acute and chronic urticaria. Additionally, 87.6% of the respondents favored up-dosing a single antihistamine agent for managing chronic urticaria. The benefits of orally disintegrating antihistamines were particularly noted for their ease of administration and patient compliance. Conclusion: Results indicate a knowledge gap in evidence-based practices among Thai clinicians. Addressing this gap through enhancing clinical guideline adherence and encouraging pharmacist involvement in patient care can improve access to medication and better disease management, ultimately improving patient outcomes while reducing the socioeconomic burden of AR and urticaria.