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Allergies in America: A Landmark Survey of Nasal Allergy Sufferers Conducted by Schulman, Ronca & Bucuvalas, Inc. February 17, 2006 Supported by: Adults Diagnosed with Nasal Allergies: Household Screening Not diagnosed, 86% Diagnosed, 14% QA. Including yourself, how many persons, aged 18 and older, live in this household (even if they are not there right now)? QB. Have any of these persons been diagnosed as having hay fever, rhinitis, or nasal allergies? QC. How many persons, 18 or older, in this household have been diagnosed with hay fever, rhinitis or nasal allergies? N=61,655 adults in 31,470 households 1 Current Nasal Allergies: Household Screening 17% 2% 76% 5% QD. Has this person/have these persons had symptoms like sneezing, itching, watery eyes, nasal congestion, or other nasal allergy symptoms in the past 12 months? QE. Does this person/do any of these persons take any medication for their hay fever, rhinitis or nasal allergies? N=6,315 households with allergic rhinitis 2 Age of Persons with Nasal Allergies 50% Screened Interviewed 40% 30% 25% 21% 22% 22% 20% 20% 17% 15% 15% 12% 11% 10% 10% 5% 3% 1% 0% 18-24 25-34 35-44 45-54 55-64 65 and older QH. What is the age/ages of the person/persons with nasal allergies, rhinitis or hay fever? N=7,758 QD3. What is your age? N=2,500 Refused 3 Gender of Persons with Nasal Allergies 100% Screened Interviewed 80% 65% 60% 60% 40% 40% 35% 20% 0% Male Female QH. What is the gender of the person/persons with nasal allergies, rhinitis or hay fever? N=4,614 QMGEN. Gender of respondent? N=2,500 4 Diagnosed with Nasal Allergies: Individual Screening 10% 90% QS1A. Has a doctor ever diagnosed you as having hay fever, rhinitis, or nasal allergies? Base: Persons identified as having been diagnosed and symptomatic or being treated for nasal allergies in household screen N=3,257 5 Current Nasal Allergies: Individual Screening 32% 1% 64% 2% QS1b. Do you still suffer from hay fever or nasal allergies? S1c. When was the most recent time that you experienced hay fever or symptoms of nasal allergies for a month or longer? QS2. In the past 12 months, have you taken a prescription medication to treat your nasal allergies? N=2,933 persons diagnosed 6 General Health Status Good 32% Fair 12% Poor/Very Poor 4% Very good 33% Excellent 19% Q1. In general, would you say your health is excellent, very good, good, only fair, poor or very poor? Unweighted N=2,500 7 Asthma and Allergies Past 12 months 20% Not past 12 months 12% Never 68% Q3c. Q3d. Have you ever been diagnosed with asthma? Have you had asthma in the past 12 months? Unweighted N=2,500 8 When Diagnosed With Nasal Allergies 25% 21% 20% 18% 15% 15% 14% 10% 9% 7% 7% 5% 5% 4% 50-59 60 and older 0% Under 6 6-11 12-17 18-29 30-39 40-49 Not sure 9 Q4. At what age were you first diagnosed with nasal allergies, rhinitis or hay fever? Unweighted N=2,500 Who Diagnosed Nasal Allergies Not sure 8% Other 3% Specialty Unknown 1% Pulmonologist 1% Internal Medicine 4% 5% Pediatrician 12% ENT 19% Allergist 20% Family Practice 27% General Practice 0% 10% 20% 30% 40% 50% 10 Q5. What was the medical specialty of the doctor who diagnosed you with nasal allergies? Unweighted N=2,500 Skin and Blood Tests for Allergies Neither 42% Not sure 2% Blood test only 8% Both 15% Skin test only 33% Q6a. Q6b. Were you given a skin test to see what you were allergic to? Were you given a blood test to see what you were allergic to? Unweighted N=2,500 11 Seasonal or Persistent Allergies Throughout the year 56% Not sure 1% Seasonal 43% Q12. Would you describe your nasal allergies as seasonal or do they occur throughout the year? Unweighted N=2,500 12 Allergy Symptoms Worse During a Particular Season or Time of Year 100% 79% 80% 71% 66% 60% 40% 20% 0% All Q12. Q13a. Seasonal Persistent Would you describe your nasal allergies as seasonal or do they occur throughout the year? In the past 12 months, have your nasal allergy symptoms been more frequent or worse during a particular season or time of year? Unweighted N=2,500 13 Season Allergies Are the Worse 100% 80% 60% 56% 45% 40% 23% 21% 20% 0% Spring Q13b. Summer Fall During what times of the year are your nasal allergies the worse? Base: Worse at certain times Unweighted N=1,778 Winter 14 Allergies Worse Outdoors or Inside Same 51% Not sure 1% Inside 9% Outside 39% Q13c. Are your nasal allergies worse when you are outdoors or inside, or is it about the same? Unweighted N=2,500 15 Symptoms During Worst Month Post-nasal drip 30% Runny Nose 16% 28% Facial Pain 11% 17% 10% Every day Ear Pain 6% 6% Most days Headache 13% Itching 12% 23% Awakened / Unable to Sleep 12% 12% 10% Stuffed up nose 40% Watering Eyes 25% Repeated Sneezing 15% 29% 0% 20% 17% 20% 40% 60% 80% Q14. During the worst one month period in the past year, did you have (symptom) every day, most days a week, a few days a week, a few days a month, less than that, or never? Unweighted N=2,500 100% 16 How Bothersome are Symptoms Post-nasal drip 28% Runny Nose 33% 26% Facial Pain 36% 16% Ear Pain 27% 11% 19% Extremely Headache 25% Itching 26% 18% Stuffed up nose 28% 40% Red, itching eyes 23% 38% 30% Watering Eyes 20% 31% Repeated Sneezing 20% 31% 0% Moderately 20% 40% 60% 80% Q15. When you have nasal allergy attacks, how bothersome are the following symptoms usually --- extremely bothersome, moderately bothersome, slightly bothersome, or not bothersome ? Unweighted N=2,500 100% 17 Most Bothersome Symptom Itching 4% Ear Pain 4% Watering Eyes 5% Most bothersome Facial Pain 7% Repeated Sneezing 9% Runny Nose 10% Red, itching eyes 10% Post-nasal drip 14% Headache 14% Stuffed up nose 22% 0% 5% 10% 15% 20% Q16. Which of these symptoms was the most bothersome to you? Base: Had bothersome symptoms. Unweighted N=2,362 25% 18 Degree of Discomfort from Allergies Can't Tolerate 38% Not sure 1% Can Ignore 6% Can Tolerate 55% Q17. In general, when you have a nasal allergy attack would you say that your discomfort is usually something you can ignore, you can’t ignore it, but you can tolerate it, or you can’t tolerate it without relief? Unweighted N=2,500 19 What Triggers Allergy Symptoms Chemicals 4% Fumes, odors 5% Plants/Trees/Leaves 6% Tobacco Smoke 6% Perfume 6% Dampness/Mold/Mildew 11% Animals 18% Weather 22% Grass 22% Dust 34% Pollen 41% 0% 10% 20% 30% 40% 50% 20 Q19. What things usually trigger or make your nasal allergy symptoms worse? Unweighted N=2,500 What Triggers Allergy Symptoms (cont.) Not Sure 9% Other 6% Nothing 1% Air quality/Dry heat/Air conditioning 1% Virus or Cold 1% Stress 1% Insescts 1% Hay/Straw/Weeds 1% Outdoors 2% Food/Drink 2% Pollution 3% 0% 10% 20% 30% 40% 50% 21 Q19. What things usually trigger or make your nasal allergy symptoms worse? Unweighted N=2,500 Employment Status of Persons with Nasal Allergies Part time 9% Retired 19% Unemployed 3% Student 5% Full time 53% Disabled 4% Homemaker 7% D6. Are you currently employed full-time, employed part-time, in the military, unemployed and looking for work, retired and not working, student, homemaker, disabled or too ill to work? Unweighted N=2,500 22 Do Nasal Allergies Keep from Working Full Time Yes 5% No 36% Working full time 53% Retired 6% 23 Q21a. Do your nasal allergies keep you from working full time? Unweighted N=2,500 Nasal Allergies Stop or Limit Working Retired 6% No 80% Limit work 9% Keep from working 5% Q21a. Do your nasal allergies keep you from working full time? Q21b. Are you limited in the kind or amount of work you do because of your nasal allergies? Unweighted N=2,500 24 Missed Work due to Nasal Allergies Yes 30% No 70% Q22a. Have you missed work in the past 12 months due to your nasal allergies? Base: Employed full time Unweighted N=1,315 25 Work Interference from Nasal Allergies Neither 48% Missed work only 10% Both 20% Interfered only 22% Q22a. Have you missed work in the past 12 months due to your nasal allergies? Q23a. Aside from actually missing work, have your nasal allergy symptoms in the past 12 months interfered with your performance at work? Base: Employed full time Unweighted N=1,315 26 Work Interference due to Allergies Some 28% Little 16% Moderate 35% None 1% A lot 20% Q23b. On days when you had nasal allergy symptoms how much did the symptoms interfere with your ability to do your job? Did the symptoms interfere a lot, a moderate amount, some, only a little, or not at all? Base: Full time, Interfered with work Unweighted N=547 27 Productivity and Allergies Mean Productivity 100% 95% 80% 72% 60% 40% 20% 0% No Symptoms Symptoms at worst Q24. Thinking about your productivity on a scale of 0 to 100, where 100 means 100% productivity, where would you rank your productivity on days when you don’t have nasal allergy symptoms? Q25. Where would you rank your productivity on the same scale of 0 to 100 … when your nasal allergies are at their worst? Base: Employed full time Unweighted N=1,315 28 Exposed to Allergens at Workplace No 40% Not sure 2% Yes 58% N26a. Are you exposed to anything at your workplace that affects your nasal allergy symptoms? Base: Full time and interferes at work. Unweighted N=511 29 Avoid Activities because of Allergies Yes 35% No 65% 30 Q27a. Do you avoid any activities because of your nasal allergies? Unweighted N=2,500 Symptoms During Worst Month 100% Sometimes Frequently 80% 36% 60% 36% 38% 40% 23% 44% 20% 15% 26% 13% 29% 8% 0% Depressed or blue Irritable Tired Embarrassed Q30. During allergy season, how often do you feel (ITEM) – frequently, sometimes, rarely or never? Unweighted N=2,500 Miserable 31 Impact of Allergies on Daily Life Little 19% Didn't really impact 14% Not sure 1% Some 26% A lot 15% Moderate 25% 32 Q31. During allergy season, would you say the condition impacted your daily life …..? Unweighted N=2,500 Nasal Allergy Control in Past Week Completely 24% Well controlled 28% Not sure 1% Not controlled 5% Poorly controlled 9% Somewhat controlled 33% Q32. Overall, how well would you say that your nasal allergies have been controlled in the last week? Would you say it was completely controlled, well controlled, somewhat controlled, poorly controlled, or not controlled at all? Unweighted N=2,500 33 Allergy Symptom Severity in Past Week Severe 11% No symptoms 23% Moderate symptoms 30% Mild symptoms 36% Q33. How would you describe your nasal allergies during the last week? Would you say you had … no symptoms, mild symptoms, moderate symptoms, or severe symptoms? Unweighted N=2,500 34 Other Conditions in the Past Week None of these 33% Pink eye Had 2% Fever 9% Skin rashes 10% Migraines 15% Earaches 16% Cold or flu 17% Heartburn or GERD 23% Sinus problems 50% 0% 20% 40% 60% 80% 100% 35 Q37. During the last week have you had ………….? Unweighted N=2,500 Usual Source of Medical Care Not sure 1% Other 2% Clinic 1% Veteran's hospital/clinic 1% Company or Union clinic 1% Hospital ER 1% Public Health clinic 3% Hospital outpatient clinic 5% Doctor's office 87% 0% 20% 40% 60% 80% Q41. Is the place that you usually go for your overall medical care, medical advice or treatment a……? Unweighted N=2,500 100% 36 Primary Health Care Provider Nurse Practitioner 7% Physician Asst 4% Doctor 87% Other 1% Not sure 1% 37 Q41b. Who do you see most often for your health care, medical advice or treatment ……? Unweighted N=2,500 Specialty of Doctor Treating Nasal Allergies Other 2% Pulmonologist 1% OB/GYN 1% ENT 6% Allergist 9% Internal medicine 12% Family practice 23% General practice 30% 0% 10% 20% 30% Q43. What is the medical specialty of the doctor that you see most often for your nasal allergies? Unweighted N=2,500 40% 50% 38 Seen Doctor for Nasal Allergies in Past 12 Months No, not seen doctor, 52% 1% 47% 39 Q42a. Have you seen a health practitioner about your nasal allergies in the past 12 months? Unweighted N =2,500 Skin Test for Nasal Allergies 4% 19% 5% 66% 7% Q45a. Has your doctor or health practitioner ever given you a skin test to see what causes your nasal allergies? Q45b. When was the most recent time you had a skin test for your nasal allergies? Unweighted N =2,500 40 Blood Test for Nasal Allergies 6% 82% 2% 7% QN46a. QN46b. 2% Has your doctor or health practitioner ever given you a blood test to see what causes your nasal allergies? When was the most recent time you had a blood test for your nasal allergies? N =2,500 41 Shots for Nasal Allergies 75% 11% 2% 9% 2% QN47a. Has your doctor or health practitioner ever given you nasal allergy shots? QN47b. When was the most recent time you had nasal allergy shots? Unweighted N =2,500 42 Drops or Extracts for Nasal Allergies 2% 1% 83% 2% 11% QN47c. Has your doctor or health practitioner ever given you nasal allergy drops or extracts by mouth or under the tongue to treat your nasal allergies? QN47d. When was the most recent time you had nasal allergy drops or extracts by mouth or under the tongue? Unweighted N =2,500 43 Shown How to Use Nasal Spray 14% 31% 2% 8% 15% 30% Q48a. Has a health practitioner ever shown you how to use a nasal spray for your nasal allergies? Q48b. When was the most recent time a health practitioner showed you how to use a nasal spray for your nasal allergies? Unweighted N=2,500 44 Follow Health Practitioner’s Advice 1% 36% 4% 4% 13% 41% Q49. Would you say that you follow your health practitioner’s advice on the management and treatment of your nasal allergies – all of the time, most of the time, some of the time, rarely or never? Unweighted N=2,500 45 Satisfaction with Health Practitioner’s Management of Your Allergies 3% 57% 7% 2% 31% Q51. Overall, how satisfied are you with your health practitioner’s management and treatment of your nasal allergies? Unweighted N=2,500 46 Changed Doctors due to Dissatisfaction 87% 13% Q52a. Have you ever changed doctors because you were dissatisfied with their management of your nasal allergies? Unweighted N=2,500 47 Seen Specialist for Nasal Allergies 14% 76% 10% 48 Q54a. Have you seen a specialist about your nasal allergies in the past 12 months? Unweighted N=2,500 Satisfaction with Specialist’s Management of Your Allergies 1% 63% 5% 10% 22% Q54c. Base: Overall, how satisfied are you with your specialist’s management and treatment of your nasal allergies? Seen specialist other than primary doctor in the past year. Unweighted N=265 49 Types of Medications Used for Allergies 50% 42% 40% 30% 28% 27% 20% 10% 3% 0% Prescription only Q62. Non-prescription only Both Neither For the current management and treatment of your nasal allergy symptoms do you use prescription medications only, non-prescription medications only, or both? Unweighted N=2,500 50 Non-Prescription Medicine for Allergies in Past 4 Weeks 100% 80% 60% 49% 51% Yes No 40% 20% 0% Q63a. In the past 4 weeks, have you used any over-the-counter, non-prescription medicine to give you relief from nasal allergy symptoms? Unweighted N=2,500 51 Non-Prescription Medicine for Allergies: Recency of Use 6% 18% 5% 54% Q63a. 16% In the past 4 weeks, have you used any over-the-counter, non-prescription medicine to give you relief from nasal allergy symptoms? Q63b. When was the most recent time that you used an over the counter, nonprescription medicine for relief from nasal allergy symptoms? Unweighted N=2,500 52 Which OTC Medicine Used Other 36% Neo-Synephrine 1% Nasalcrom 1% Tavist 1% Chloritrimenton 2% Alavert 2% Actifed 3% Afrin 5% Cold medicines 6% Tylenol Allergy 10% Sudafed 17% Benadryl 20% Claratin 22% 0% Q63c. Base: 10% 20% 30% What is the name of the over-the-counter medicines you take/took for nasal allergies? Used in past 4 weeks. Unweighted N=1,345 40% 50% 53 Satisfaction with Recent OTC Medicine for Nasal Allergies 1% 41% 3% 7% 48% Q63f. How satisfied are you with the over-the-counter medicine you used for your nasal allergies in the past 4 weeks? Base: Used OTC for nasal allergies in the past 4 weeks. Unweighted N=1,344 54 Prescription Nasal Spray for Allergies in Past 4 Weeks 100% 80% 66% 60% 40% 34% 20% 0% Yes No 55 Q64a. In the past 4 weeks, have you used any prescription nasal spray for your nasal allergies? Unweighted N=2,500 Prescription Nasal Spray for Allergies: Recency of Use 1% 18% 24% 7% 14% 36% Q64a. In the past 4 weeks, have you used any prescription nasal sprays for your nasal allergies? Q64b. When was the most recent time that you used a prescription nasal spray for your nasal allergies? Unweighted N=2,500 56 Which Prescription Nasal Spray Used Other 9% Naserel 3% Astelin 5% Rhinocort 10% Nasacort 14% Nasonex 21% Flonase 41% 0% 10% 20% 30% Q64c. What is the name of the prescription nasal spray you take/took for nasal allergies? Base: Used in past 4 weeks. Unweighted N=919 40% 50% 57 How Many Symptoms Relieved by Nasal Spray 34% 3% 46% 1% 16% Q65. Does your current prescription nasal spray give you relief from all of your symptoms, most symptoms, some symptoms, or no symptoms? Base: Use prescription nasal spray. Unweighted N=919 58 How Quickly Does it Relieve 50% 40% 37% 30% 21% 20% 12% 10% 8% 4% 2% 1% 1% 3-4 hours 5-6 hours 7-10 hours 2% 0% Within 1 hour 1 hour 2 hours 11-23 hours 1-6 days Q68. How long does it take for your current prescription nasal spray to begin giving you symptom relief? Unweighted N=919 One week or more 59 Does Effectiveness Wear Off 45% 7% 48% Q69a. Does your current prescription nasal spray lose effectiveness over the course of the day or night, or does it remain as effective as when you first took it? Base: Used prescription nasal spray Unweighted N=919 60 When Begins Losing Effectiveness Not sure 5% 24 hours or longer 5% 16-23 hours 3% 12-15 hours 17% 8-11 hours 20% 4-7 hours 32% Less than 4 hours 18% 0% Q69b. Base: 10% 20% 30% How long after taking your current nasal allergy medicine does it begin losing effectiveness? Nasal spray loses effectiveness. Unweighted N=440 40% 50% 61 Satisfaction with Recent Rx Nasal Spray for Nasal Allergies 1% 49% 4% 6% 39% Q70a. How satisfied are you with the prescription nasal spray you used for your nasal allergies in the past 4 weeks? Base: Used Rx nasal spray for nasal allergies in the past 4 weeks. Unweighted N=919 62 Satisfaction with Rx Nasal Sprays for Nasal Allergies 34% 4% 38% 12% 12% Q70b. In general, how satisfied have you been with the prescription nasal spray you have used for your nasal allergies in the past? Base: Ever used Rx nasal spray for nasal allergies. Unweighted N=2,033 63 Reason for Not Using Rx Nasal Spray Recently Other 4% Causes nosebleeds 1% Taste/Smell 1% Hard to use 1% Dependence concerns 1% Interferes with condition/meds. 2% Don't tolerate 2% No insurance/Cost too high 6% Don't like/Prefer other meds. 7% Don't like sprays 8% Side effects 9% Haven't seen doctor/Received prescription 11% Not effective 11% Not bad enough 11% No symptoms 30% 0% Q71. 10% 20% 30% Why haven’t you used a prescription nasal spray you take/took for nasal allergies in the past 4 weeks? Base: Used in past but not past 4 weeks. Unweighted N=1,156 40% 50% 64 Other Prescriptions for Allergies in Past 4 Weeks 100% 77% 80% 60% 40% 22% 20% 0% Yes Q72a. No Have you taken any other prescription medications for your nasal allergies in the past 4 weeks? Unweighted N=2,500 65 Other Prescription Medicine Used Not sure 3% Other 24% Fexofenadine 1% Prednisone/Medrol dose pack 1% Clarinex 7% Claritin Rx 9% Singulaire 14% Zyrtec 26% Allegra 33% 0% Q72b. Base: 10% 20% 30% What is the name of the other prescription medicine you take/took for nasal allergies? Used in past 4 weeks. Unweighted N=576 40% 50% 66 How Many Symptoms Relieved by Nasal Spray 23% 1% 50% 2% 22% Q73. Does this prescription medicine give you relief from all of your symptoms, most symptoms, some symptoms, or no symptoms? Base: Use other prescription medicine. Unweighted N=576 67 How Quickly Does it Relieve 50% 40% 30% 25% 23% 20% 14% 10% 10% 3% 3% 1% 1% 5-6 hours 7-10 hours 3% 0% Within 1 hour 1 hour 2 hours 3-4 hours 11-23 hours Q76. How long does it take for this prescription medicine to begin giving you symptom relief? Base: Use other prescription medicine. Unweighted N=576 1-6 days One week or more 68 Does Effectiveness Wear Off 51% 6% 42% Q77a. Does this prescription medicine lose effectiveness over the course of the day or night, or does it remain as effective as when you first took it? Base: Use other prescription medicine. Unweighted N=576 69 When Begins Losing Effectiveness Not sure 5% 24 hours or longer 5% 16-23 hours 7% 12-15 hours 20% 8-11 hours 29% 4-7 hours 24% Less than 4 hours 9% 0% Q77b. Base: 10% 20% 30% How long after taking this nasal allergy medicine does it begin losing effectiveness? Other prescription medicine loses effectiveness. Unweighted N=243 40% 50% 70 Satisfaction with Other Prescription Medicine for Nasal Allergies 1% 3% 52% 7% 38% Q78. How satisfied are you with the other prescription medicine you used for your nasal allergies in the past 4 weeks? Base: Used other prescription medicine for nasal allergies in the past 4 weeks. Unweighted N=576 71 Medicine for Allergies in Past 4 Weeks 100% 80% 71% 60% 49% 44% 40% 34% 29% 22% 20% 0% OTC Q63a. Rx Nasal Spray Other Rx Any Rx Any Medication No Medication In the past 4 weeks, have you used any over-the-counter, non-prescription medicine to give you relief from nasal allergy symptoms? Q64a. In the past 4 weeks, have you used any prescription nasal spray for your nasal allergies? Q72a. Have you taken any other prescription medications for your nasal allergies in the past 4 weeks? Unweighted N=2,500 72 Use of Prescription Meds for Nasal Allergies 100% 80% 60% 51% 40% 31% 17% 20% 1% 0% All year Q79. Only Part Year Never take Not sure Do you take prescription medicines for your nasal allergies all through the year or only during the times of the year that your nasal allergies are the worst? Unweighted N=2,500 73 Change Prescription Medicines for Nasal Allergies 2% 29% 10% 8% 38% 12% Q81a. How often do you change nasal allergy medicines ---several times each year, once a year, every few years, only rarely or never? Unweighted N=2,500 74 Why Changed Medicine for Nasal Allergies Other 4% Not sure 3% Not fast enough 1% Haven't changed allergy medicines 2% Taken off market 2% Not long lasting enough 2% Availability/ Convenience/ Free samples 3% Developed an immunity 3% Safety concerns 3% Not covered 3% Didn't treat symptoms 4% Cost/co-pay 5% Bothersome side effects 8% Patient wanted to try other 11% Doctor wanted to try other 23% Not effective enough 37% 0% Q81b. 10% 20% 30% 40% Why have you changed nasal allergy medicines? Anything else? Base: Have changed nasal allergy medicines. Unweighted N=1,723 50% 75 Asked Doctor to Change Medication 66% 34% Q82a. Have you ever asked your doctor to change your nasal allergy medication because you were dissatisfied with it? Unweighted N=2,500 76 Why Dissatisfied with Nasal Allergy Medicine Not sure 2% Other 4% Hard to administer 1% Cost/co-pay 1% Not covered 1% Didn't provide 24 hour relief 10% Effectiveness wore off 12% Bothersome side effects 21% Wasn't effective 66% 0% Q82c. 20% 40% 60% Why were you dissatisfied with that medicine? Base: Have asked doctor to change nasal allergy medicines. Unweighted N=860 80% 100% 77 How Quickly Supposed to Relieve Not sure 15% 25 hours or longer 10% 13-24 hours 4% 10-12 hours 1% 7-9 hours 1% 4-6 hours 4% 1-3 hours 17% Within 1 hour 47% 0% 10% 20% 30% 40% Q85. How quickly are prescription medicines supposed to begin providing symptom relief for nasal allergies? Unweighted N=2,500 50% 78 How Long Supposed to Relieve 50% 40% 30% 30% 21% 19% 20% 16% 10% 10% 4% 0% Less than 6 hours 6-11 hours 12-17 hours 18-23 hours 24 hours or longer Not sure 79 Q86. How long are prescription medicines supposed to provide symptom relief for nasal allergies? Unweighted N=2,500 Effectiveness Ever Wore Off before 24 Hours 33% 9% 58% Q87a. Have you ever found that the effectiveness of a product that promised 24 hour relief began wearing off earlier? Unweighted N=2,500 80 Effectiveness Wore Off: Multiple Products 4% 33% 9% 16% 39% Q87a. Have you ever found that the effectiveness of a product that promised 24 hour relief began wearing off earlier? Q87b. Has this happened with more than one nasal allergy product? Unweighted N=2,500 81 When Does Effectiveness Wear Off 50% 40% 30% 25% 20% 15% 15% 3-4 hours 5-6 hours 19% 19% 7-10 hours 11 or more 10% 3% 3% 2% 0% Within 1 hour Q87c. 1 hour 2 hours About how long after you started taking it does a nasal allergy medicine’s effectiveness begin wearing off? Base: Found nasal allergy medicine offering 24 hour relief wearing off. Unweighted N=1,461 Not sure 82 Stopped Taking Because Effectiveness Wore Off 100% 80% 60% 40% 57% 33% 20% 0% All Patients Unweighted N=2,500 Experienced Wear-off Unweighted N=1,461 83 Q87d. Have you ever stopped taking a product for your nasal allergies because its effectiveness had worn off? Effectiveness Wears Off Over Time 2% 40% 6% 15% 38% Q88a. Have you ever found that a product’s effectiveness in treating your nasal allergy symptoms wears off over time even when you are taking the medicine as prescribed? Q88b. Has this happened to you with more than one nasal allergy product? Unweighted N=2,500 84 When Does Effectiveness Wear Off 50% 40% 30% 27% 20% 13% 12% 13% 12% 10% 10% 7% 6% 1 month 2 months 0% Within 1 month Q88c. 3-4 months 5-6 months 7-10 months 11 or more months About how long after you started taking it does a nasal allergy medicine’s effectiveness begin wearing off even when taken as prescribed? Base: Found nasal allergy medicine wearing off. Unweighted N=1,364 Not sure 85 Stopped Taking Because Effectiveness Wore Off 100% 80% 66% 60% 40% 36% 20% 0% All Patients Unweighted N=2,500 Experienced Wear-off Unweighted N=1,364 86 Q88d. Have you ever stopped taking a product for your nasal allergies because its effectiveness had worn off? Nasal Allergy Meds Cause Nosebleeds 20% 78% 2% Q89a. Have any of the medicines that you have taken for your nasal allergy ever caused nosebleeds? Unweighted N=2,500 87 How Bothersome were Nosebleeds 32% 8% 1% 28% 31% 88 Q89b. How bothersome were those nosebleeds? Base: Medicine caused nosebleeds. Unweighted N=501 Side Effects of Allergy Medicines 50% Some Most 40% 25% All 22% 30% 26% 17% 20% 8% 10% 7% 12% 11% 12% 7% 8% 10% 3% 0% Bad taste Q90. 3% 11% Burning Dripping Drying feeling down throat 2% 2% 4% Headaches Drowsiness How many of the medicines that you have taken for allergy had the following types of side effects --all, most, some, few or none? Unweighted N=2,500 89 How Bothersome are Side Effects 50% Moderately Extremely 40% 30% 20% 22% 21% 20% 13% 15% 11% 10% 7% 7% Bad taste Burning 13% 12% 12% 12% Dripping down throat Drying feeling Headaches Drowsiness 0% Q91. How bothersome are the following side effects of nasal allergy medicines --- extremely, moderately, slightly or not bothersome? Unweighted N=2,500 90 Try to Avoid Certain Medicines 62% 1% 36% 91 Q100a. Are there any nasal allergy medications that you try to avoid using? Unweighted N=2,500 Reason Stopped Taking Nasal Allergy Prescription None of these 39% Hard to administer 3% Dosing schedule was difficult 4% Co-pay was too high 11% Not covered 14% Bothersome side effects 25% Didn't provide 24 hour relief 32% Effectiveness began wearing off 35% Didn't find it effective 37% 0% Q94. 10% 20% 30% Have you ever stopped taking a nasal allergy medicine prescribed by your doctor because…. Unweighted N=2,500 40% 50% 92 Tell Doctor when Stop Taking Rx Meds 51% 1% 48% Q95. When you have stopped taking a nasal allergy medicine for one of these reasons, do you always tell your doctor right away? Base: Have stopped taking nasal allergy medicine prescribed by doctor. Unweighted N=1,490 93 Get Money’s Worth from Rx Meds 55% 10% 34% Q97. Overall, do you feel that patients get their money’s worth out of prescription medicines for nasal allergies? Unweighted N=2,500 94 Most Important for Nasal Allergy Medicine Not sure 1% Low cost 5% Few side effects 6% Easy to take 2% Complete symptom relief 37% Long lasting relief 32% Fast symptom relief 17% 0% 10% 20% 30% Q98. In choosing a nasal allergy medicine, which would be the most important to you …? Unweighted N=2,500 40% 50% 95 Important for Nasal Allergy Medicine Not sure 1% 1% Most Low cost 5% Few side effects 6% Easy to take 2% 13% 13% 4% Complete symptom relief 37% Long lasting relief 15% 32% Fast symptom relief 17% 0% Next 30% 22% 20% 40% 60% Q98. In choosing a nasal allergy medicine, which would be the most important to you …? Q99. What would be the next most important to you? Unweighted N=2,500 80% 100% 96 How Many Symptoms Relieved for Success 8% 53% 4% 1% 1% 33% Q101. How many symptoms would a nasal allergy medicine have to relieve for you to consider it a successful treatment --- all, most, some, a few or none? Unweighted N=2,500 97 Percent Relief for Success 100% 85% 86% All Patients N=2,500 No symtoms 84% 85% Mild symptoms Moderate symptoms 83% 80% 60% 40% 20% 0% Severe symptoms Q102. On a scale of 0 to 100 percent, what percent symptom relief would you expect from a nasal allergy medicine for it to be considered a successful treatment? Q33. How would you describe your nasal allergy symptoms in the past week? 98 How Quickly Must Relieve Not sure 5% 11 hours or longer 8% 7-10 hours 1% 5-6 hours 1% 3-4 hours 4% 2 hours 10% 1 hour 27% Within 1 hour 43% 0% Q103. 10% 20% 30% 40% How quickly after taking would a nasal allergy medicine have to begin relieving symptoms for you to consider it a successful treatment? Unweighted N=2,500 50% 99 How Long Must Last Not sure 3% 24 hours or longer 27% 16-23 hours 5% 12-15 hours 24% 8-11 hours 18% 4-7 hours 18% Less than 4 hours 5% 0% Q104. 10% 20% 30% 40% How long after you take a dose of nasal allergy medicine should symptom relief last for you to consider it a successful treatment? Unweighted N=2,500 50% 100 Failed to Follow Physician Instructions Doctor's instructions hard to follow 3% Poor toleration 19% Concern about long term use 19% Cost of drugs 21% Worry about side effects 22% Troublesome side effects 27% Lack of symptoms 35% Loss of effectiveness over time 37% Lack of symptom relief 41% 0% Q108. 10% 20% 30% 40% People with nasal allergies sometimes fail to follow their physician’s instructions about their medicines for allergies. Have you ever failed to take an allergy medicine as prescribed because of …… Unweighted N=2,500 50% 101 Allergies Impact on Activities with Children 10% 87% 3% Q109b. Do your nasal allergies interfere with activities that you would like to do with the children? Q109c. Do your nasal allergies ever make you feel guilty when they interfere with activities with the children? Base: Children under 18 Unweighted N=882 102 Attitudes about Nasal Allergies Nasal allegies can cause sinus infections 64% Nasal allergies can make asthma worse 21% 56% Frequent nasal allergy symptoms can be prevented 22% 19% 36% Agree strongly There are no truly effective treatments for nasal allergies 15% Nasal allergies usually cause some lifestyle limitations Agree somewhat 20% 28% 43% Nasal allergies are serious health problem in US 55% 0% 20% 29% 40% 60% Q110. Now I am going to read you a series of statements. As I read each statement , please tell me whether you agree strongly, agree somewhat, disagree somewhat or disagree strongly with the statement. Unweighted N=2,500 80% 100% 103 Source of Health Insurance Not covered Not sure 11% 1% Other 2% Military/VA/Champus 3% Medicaid 5% Medicare 14% Bought directly by you 14% Through work, school or union 67% 0% 20% 40% 60% Q111a. Do you have any sort of health insurance or health plan to cover your health care costs? Q111c. Is your coverage under that/those plans from ….. Unweighted N=2,500 80% 100% 104 How Much of Prescription Drug Costs Covered 19% 3% 4% 3% 50% 11% 10% Q111d. How much of the costs of your prescription drugs is covered by your health plan --all, most, some, little or none? Unweighted N=2,500 105 Insurance Restricts Type Of Medicine 59% 10% 11% 20% Q111f. Does your insurance restrict your doctor from prescribing specific nasal allergy medications for you? Unweighted N=2,500 106 Need for Patient Education 40% 7% 2% 49% 3% Q113. How much need do you think there is for better education of people with nasal allergies about their condition and its treatment? Unweighted N=2,500 107 Family History of Nasal Allergies Not sure 2% 17% None of these Grandparents 13% Children 46% Brothers or sisters 49% Mother 37% Father 27% 0% 20% 40% 60% 80% 100% 108 Q116. Do any of the following relatives of yours have nasal allergies? Unweighted N=2,500 Pets in the Household No pets in house 44% Other 2% Rabbit 1% Hamster/gerbil 1% Fish 2% Bird 3% Cat 28% Dog 40% 0% 10% 20% 30% 40% 50% 109 Q117a. Do you have any pets living in your house? Q117b. What kind of pet or pets? Unweighted N=2,500 Smokers in Household 76% 24% 110 Q118a. Does anyone in your household smoke? Unweighted N=2,500 Allergies in America: Survey of Health Professionals Conducted by Schulman, Ronca & Bucuvalas, Inc. February 28, 2006 Supported by: Study Design Population Sampling Frame Interview Length Completed Sample Population Aged 18+ National RDD 34.8 minutes 2,500 AMA/AOA Master List 19.4 minutes Cross-section: 1/5/06-1/31/06 Health Professional Survey -- Adult Primary Care -- Allergy -- Otolaryngology -- Nurse practitioner -- Physician assistant 100 100 100 50 50 Physician Survey: 1/17/06-2/14/06 112 Health Provider Type 50% 45% 40% 35% 30% 25% 25% 25% 25% 20% 15% 13% 13% Nurse Practitioner Physician Asst 10% 5% 0% ENT Base: Total completed interviews N=400 Allergist Primary care 113 Primary Ambulatory Care Setting Other 1% Hospital Outpatient 1% 4% Nurse Prac./Physician Asst. Primary care Allergist ENT 6% 2% 2% 4% HMO 1% 34% 6% Clinic 1% 2% 16% 22% Multi-specialty group 10% 17% 18% Single-specialty group 25% 44% 44% 19% 41% Solo practice 45% 34% 0% 5% 10% 15% 20% 25% 30% 35% 40% Q3. In what type of ambulatory care setting do you spend MOST of your (out-patient) patient care time during a usual work week? Is it… N=400 45% 50% 114 Patients Seen on Outpatient Basis 120 113 103 97 Weekly average 100 80 80 60 40 20 0 ENT Allergist Primary Care Nurse Prac./Physician Asst 115 Q4. In an average week, about how many patients do you see on an outpatient basis? N=400 Percent of Patients with Rhinitis 100% Weekly average 80% 64% 60% 40% 33% 22% 22% Primary Care Nurse Prac./Physician Asst 20% 0% ENT Q5. Allergist About what percent of the outpatients you see each week have allergic rhinitis? N=400 116 How Bothersome are Symptoms Nurse Prac./Physician Asst. Primary care 10% 77% 8% Allergist 84% 26% ENT 73% 16% 0% 81% 20% 40% Extremely 60% 80% 100% Moderately Q6. For most patients that you see with allergic rhinitis, how bothersome are their nasal allergy symptoms? Would you say they are extremely bothersome, moderately bothersome, slightly bothersome or not bothersome? N=400 117 Most Bothersome Symptoms 22% 90% 90% Nasal congestion 98% 96% 14% 72% Post-nasal drip 78% 73% 75% 10% 63% Runny nose 74% 69% 68% 5% 51% Watery eyes 57% 50% Patients (single choice) Nurse Prac./Physician Asst. 45% Primary care 10% 46% 45% Red/Itching eyes Allergist 53% ENT 37% 0% 20% 40% 60% 80% Q7. Which of the following nasal allergy symptoms are most bothersome to your patients? N=400 PQ16. Which of these symptoms was the most bothersome to you? Base: Had bothersome symptoms. Unweighted N=2,362 100% 118 Most Bothersome Symptoms (Cont.) 7% 37% Facial pain 41% 55% 14% 36% Headache 42% 50% 9% 29% Repeated sneezing 47% 31% 4% 30% Itching Patients (single choice) 41% 37% Nurse Prac./Physician Asst. Primary care 4% Ear pain 31% Allergist 31% ENT 45% 0% Q7. PQ16. 20% 40% 60% 80% Which of the following nasal allergy symptoms are most bothersome to your patients? N=400 Which of these symptoms was the most bothersome to you? Base: Had bothersome symptoms. Unweighted N=2,362 100% 119 Discomfort During Allergy Attack Patients 38% 55% Nurse Prac./Physician Asst. 45% Primary care 44% 55% 55% Allergist 60% ENT 38% 45% 0% 20% 55% 40% Can't tolerate 60% 80% 100% Can't ignore In general, would you say that patients’ discomfort during a nasal allergy attack is usually something they can ignore, they can’t ignore it, but they can tolerate it, or they can’t tolerate it without relief? N=400 PQ17. In general, when you have a nasal allergy attack would you say that your discomfort is usually something you can ignore, you can’t ignore it, but you can tolerate it, or you can’t tolerate it without relief? Unweighted N=2,500 Q8. 120 Patients Missing Work due to Rhinitis Patients (yes) Nurse Prac./Physician Asst. 30% 3% Primary care 27% 14% Allergist ENT 13% 32% 19% 3% 0% 40% 19% 10% 23% 20% All (91% to 100%) 30% 40% Most (51% to 90%) 50% 60% 70% Some (11% to 50%) Q9. Among your patients with allergic rhinitis who are employed, how many would you estimate have missed work in the past 12 months due to their nasal allergies? N=400 PQ22a. Have you missed work in the past 12 months due to your nasal allergies? Base: Employed full time Unweighted N=1,315 121 Productivity when Nasal Allergies are at Their Worst 100% Weekly average 80% 72% 65% 64% 60% 62% 60% 40% 20% 0% ENT Q10. Allergist Primary Care Nurse Prac./ Physician Asst Patients Thinking about productivity at work on a scale from 0 to 100, where 100 means 100% productivity, where would you rank the productivity of persons with allergic rhinitis, when their nasal allergies are at their worst? N=400 PQ24. Thinking about your productivity on a scale of 0 to 100, where 100 means 100% productivity, where would you rank your productivity on days when you don’t have nasal allergy symptoms? PQ25. Where would you rank your productivity on the same scale of 0 to 100 … when your nasal allergies are at their worst? Base: Employed full 122 time Unweighted N=1,315 Impact of Allergies on Daily Life Patients 15% Nurse Prac./Physician Asst. 25% 34% Primary care 47% 18% 63% Allergist 47% ENT 44% 30% 0% 62% 20% 40% A lot 60% 80% 100% Moderate Q11. For the average patient with allergic rhinitis, during allergy season, would you say the condition impacted their daily life a lot, impacted their daily life a moderate amount, impacted their daily life some, impacted their daily life a little, or does not really impact their daily life? N=400 PQ31. During allergy season, would you say the condition impacted your daily life …..? Unweighted N=2,500 123 Classification of Nasal Allergies 100% Weekly average 80% 71% 60% 61% 60% 41% 40% 20% 0% ENT Allergist Primary Care Nurse Prac./Physician Asst Q12. Do you classify the severity of nasal allergies in patients [DOCTOR VERSION: when you make the diagnosis] [PA/NP VERSION: when you initially see them]? N=400 124 Percent of Patients with Seasonal Allergies 100% Weekly average 80% 60% 55% 57% 49% 43% 39% 40% 20% 0% ENT Allergist Primary Care Nurse Prac. /Physician Asst Patients Q13a. What proportion of your patients with nasal allergies would you classify as having seasonal rather than perennial allergies? N=400 PQ12. Would you describe your nasal allergies as seasonal or do they occur throughout the year? Unweighted N=2,500 125 Proportion of Patients Classified by Symptom Severity Nurse Prac./Physician Asst. 26% Primary care 41% 23% Allergist 34% 42% 34% 35% ENT 45% 28% 0% 20% 46% 20% Severe 40% 27% 60% 80% Moderate 100% Mild 126 Q13b. What proportion of your patients with nasal allergies would you classify as having…? N=400 Skin Test to Confirm Diagnosis Patients (yes) Nurse Prac./Physician Asst. Primary care 49% 3% 3% 3% 2% 25% 27% Allergist ENT 56% 3% 0% 27% 20% Always Q14. 39% 4% 43% 40% 60% Most of the time 80% 100% Sometimes How often do you conduct a skin test, either in your office or by referral, when making or confirming a diagnosis of allergic rhinitis…? N=400 PQ6a. Were you given a skin test to see what you were allergic to? Unweighted N=2,500 127 Blood Test to Confirm Diagnosis Patients (yes) Nurse Prac./Physician Asst. Primary care Allergist ENT 23% 1% 5% 19% 2% 3% 27% 1% 1% 3% 0% 33% 12% 10% Always Q15. 28% 20% 30% Most of the time 40% 50% Sometimes How often do you conduct a blood test, either in your office or by referral, when making or confirming a diagnosis of allergic rhinitis…? N=400 PQ6b. Were you given a blood test to see what you were allergic to? Unweighted N=2,500 128 Allergy Shots to Treat Nasal Allergies Patients (ever) Nurse Prac./Physician Asst. 25% 4% Primary care 9% Allergist 9% ENT 10% 27% 3% 35% 36% 13% 0% 18% 20% All Q16. 44% 44% 40% 60% Most 80% 100% Some Among your patients with allergic rhinitis, do you give allergy shots to or refer patients to get allergy shots to treat nasal allergies to all, most, some, a few or none? N=400 PQN47a. Has your doctor or health practitioner ever given you nasal allergy shots? Unweighted N =2,500 129 Allergy Drops to Treat Nasal Allergies Patients (ever) 17% Nurse Prac./Physician Asst. 3% Primary care 4% Allergist ENT 7% 3% 3% 2% 0% 8% 12% 6% 1% 13% 5% All 10% 15% Most 20% 25% 30% Some Q17. Among your patients with allergic rhinitis, do you give or refer patients to get allergy drops or extracts by mouth or under the tongue to treat nasal allergies to all, most, some, a few or none? N=400 PQN47c. Has your doctor or health practitioner ever given you nasal allergy drops or extracts by mouth or under the tongue to treat your nasal allergies? Unweighted N =2,500 130 How Often Show How to Use Nasal Spray Patients 31% Nurse Prac./Physician Asst. 15% Primary care 15% 22% 3% 73% 1% Allergist 72% 40% ENT 22% 0% At least once a year 15% 3% 4% 20% Every few years 55% 64% 40% 60% 80% 100% When first prescribed/5 years or more Q18. How often do you show patients how to use a nasal spray for their nasal allergies? N=400 PQ48a. Has a health practitioner ever shown you how to use a nasal spray for your nasal allergies? PQ48b. When was the most recent time a health practitioner showed you how to use a nasal spray for your nasal allergies? Unweighted N=2,500 131 How Often Patients Follow Advice 100% Most of the time All of the time 80% 41% 60% 40% 67% 70% 57% 39% 20% 1% 1% ENT Allergist 36% 1% 0% Primary care Nurse Prac./ Physician Asst. Patients Q19. Would you say that most of your patients with allergic rhinitis follow your advice on the management and treatment of nasal allergies…? N=400 PQ49. Would you say that you follow your health practitioner’s advice on the management and treatment of your nasal allergies – all of the time, most of the time, some of the time, rarely or never? Unweighted N=2,500 132 Percent of Patients Very Satisfied With Disease Management 100% 8% 17% 28% 31% 80% 60% 87% 40% 78% 72% 62% 57% 20% 0% 3% 4% ENT Allergist All (91% to 100%) 3% Primary care Most (51% to 90%) Nurse Prac./ Physician Asst. Patients Some (11% to 50%) Q20. Approximately, what proportion of your patients with nasal allergies would you say are VERY satisfied with the management of their disease? Would you say… N=400 PQ51. Overall, how satisfied are you with your health practitioner’s management and treatment of your nasal allergies? Unweighted N=2,500 133 Effect of Medical Treatment on Quality of Life Nurse Prac./Physician Asst. 41% 51% Primary care 42% 46% Allergist 26% 74% ENT 34% 60% 0% 20% 40% A lot 60% 80% 100% Moderate 134 Q21. How much effect does medical treatment have on the quality of life for an adult with allergic rhinitis? N=400 How Often Patients Change Allergy Medications Patients 10% Nurse Prac./Physician Asst. 8% 12% 20% Primary care 25% 13% Allergist 20% 29% 29% 20% Several times a year 17% 39% 34% 21% 0% 35% 28% 17% ENT 38% 40% Once a year 19% 38% 60% 12% 80% Every few years 100% Rarely How often do your patients with allergic rhinitis change allergy medicines – sever times each year, once a year, once every few years, only rarely or never? N=400 PQ81a. How often do you change nasal allergy medicines ---several times each year, once a year, every few years, only rarely or never? Unweighted N=2,500 Q22. 135 Patients Ask to Change Allergy Medicine Patients (yes) Nurse Prac./Physician Asst. Primary care Allergist ENT 34% 1% 16% 56% 1% 5% 1% 63% 13% 61% 1% 9% 0% 51% 20% All (91% to 100%) 40% 60% Most (51% to 90%) 80% 100% Some (11% to 50%) Q23a. What proportion of your patients with allergic rhinitis have asked you to change their allergy medication because they were dissatisfied with it – all, most , some, only a few or none? N=400 PQ82a. Have you ever asked your doctor to change your nasal allergy medication because you were dissatisfied with it? Unweighted N=2,500 136 Reasons for Dissatisfaction with Medicine Not effective Bothersome side effects Effectiveness wears off Not covered by insurance Patients Nurse Prac./Physician Asst. Primary care Allergist ENT Co-pay too high No relief through day/night 0% 20% 40% 60% 80% Why are patients dissatisfied with their allergy medicine? [Unaided question] Base: Have asked to change medicine because dissatisfied N=395 PQ82c. Why were you dissatisfied with that medicine? Base: Have asked doctor to change nasal allergy medicines. Unweighted N=860 100% Q23b. 137 Reasons for Dissatisfaction with Medicine (cont.) Wanted to try something else Doctor wanted to switch Don't like nasal spray Cost/Expensive Dosing schedule difficult Patients Nurse Prac./Physician Asst. Primary care Allergist ENT Hard to administer Other 0% 20% 40% 60% 80% Why are patients dissatisfied with their allergy medicine? [Unaided question] Base: Have asked to change medicine because dissatisfied N=395 PQ82c. Why were you dissatisfied with that medicine? Base: Have asked doctor to change nasal allergy medicines. Unweighted N=860 100% Q23b. 138 Most Important Attribute of Allergy Medicine Low cost Few side effects Easy to take Complete symptom relief Patients Nurse Prac./Physician Asst. Primary care Allergist ENT Long lasting symptom relief Fast symptom relief 0% 20% 40% 60% 80% Q38. In choosing a medicine for nasal allergies, which would be most important to your patients? N=400 PQ98. In choosing a nasal allergy medicine, which would be the most important to you …? Unweighted N=2,500 100% 139 Most Important Attributes of Allergy Medicine Patients Nurse Prac./Physician Asst. Primary care Allergist ENT Low cost Few side effects Easy to take Complete symptom relief Long lasting symptom relief Fast symptom relief 0% 20% 40% 60% 80% In choosing a medicine for nasal allergies, which would be most important to your patients? Q39. What would be next most important to your patients? N=399 PQ98. In choosing a nasal allergy medicine, which would be the most important to you …? PQ99. What would be the next most important to you? Unweighted N=2,500 100% Q38. 140 Preferred Medicines for Moderate to Severe Persistent Allergy Symptoms 53% 54% 57% 61% Inhaled Corticosteroids Antihis. RX 28% Antihis. OTC Antihis./decon. RX 16% 9% 11% 9% 6% 7% 10% 5% Antichol. Nasal spray Internasal antihistamines 5% 6% 4% 4% Oral antihistamines 2% 3% 3% 6% Non sedating antihistamines 39% 17% 16% 5% 4% 41% 37% Nurse Prac./Physician Asst. Primary care Allergist 8% 4% 1% 5% 0% ENT 20% 40% 60% 80% Q31. What class or classes of medication is your preferred choice for adults with moderate to severe persistent allergy symptoms? [Unaided response] N=400 100% 141 Preferred Medicines for Moderate to Severe Persistent Allergy Symptoms (cont.) Nasal steroids Medication names Decon. OTC Antihis./decon. OTC Leukotrienes Decongestant nasal spray OTC Nurse Prac./Physician Asst. Primary care Cromolyn Allergist ENT Other 0% 20% 40% 60% 80% Q31. What class or classes of medication is your preferred choice for adults with moderate to severe persistent allergy symptoms? [Unaided response] N=400 100% 142 Patients Using Intra-Nasal Corticosteroids 100% Past 4 weeks Past 6 months Past year 80% 60% 7% 40% 14% 72% 72% 58% 54% 20% 36% 0% ENT Q32. Allergist Primary care Nurse Prac./ Physician Asst. Patients What proportion of your patients with allergic rhinitis are currently using an intra-nasal corticosteroid for their condition? N=400 143 PQ64a. In the past 4 weeks, have you used any prescription nasal sprays for your nasal allergies? PQ64b. When was the most recent time that you used a prescription nasal spray for your nasal allergies? Unweighted N=2,500 Symptoms Relieved by Intra-nasal Corticosteroids 100% 19% 23% 30% 25% 80% 34% 60% 40% 80% 72% 46% 73% 70% 20% 16% 4% 1% Primary care Nurse Prac./ Physician Asst. Most Some 0% ENT Allergist All Patients Q33. Do intra-nasal corticosteroids give most patients relief from all of their symptoms, most symptoms, some symptoms, few symptoms, or no symptoms? N=400 PQ65. Does your current prescription nasal spray give you relief from all of your symptoms, most symptoms, some symptoms, or no symptoms? Base: Use prescription nasal spray. Unweighted N=919 144 Time for Intra-nasal Corticosteroids Relief Patients 71% Nurse Prac./Physician Asst. 14% Primary care 43% 23% Allergist 35% 24% 63% 11% 0% 4% 50% 18% ENT 12% 17% 53% 20% 35% 40% Hours 60% Days 80% 100% Weeks Q34. How long does it take an intra-nasal corticosteroid to begin giving symptoms relief? N=400 PQ68. How long does it take for your current prescription nasal spray to begin giving you symptom relief? Unweighted N=919 145 How Long Intra-nasals Provide Relief 100% 24 hours or longer 80% 60% 40% 20% 0% ENT Allergist Primary care Nurse Prac./Physician Asst. 146 Q25. How long are intra-nasal corticosteroids supposed to provide symptoms relief for nasal allergies? N=400 Do Intra-nasals Lose Effectiveness 100% 80% Yes 60% 48% 48% 37% 40% 29% 25% 20% 0% ENT Q35a. PQ69a. Allergist Primary care Nurse Prac./ Physician Asst. Patients Do intra-nasal corticosteroids lose effectiveness over the course of the day or night, or do they remain as effective as when the patient first took it? N=400 Does your current prescription nasal spray lose effectiveness over the course of the day or night, or does it remain as effective as when you first took it? Base: Used prescription nasal spray Unweighted N=919 147 Time Until Intra-nasals Lose Effectiveness 24 hours or longer 100% 80% 60% 40% 32% 30% 25% 21% 20% 5% 0% ENT Allergist Primary care Nurse Prac./ Physician Asst. Patients Q35b. How long after taking an intra-nasal corticosteroid does it begin losing effectiveness allergies? Base: Lose effectiveness over day and night N=139 PQ69b. How long after taking your current nasal allergy medicine does it begin losing effectiveness? Base: Nasal spray loses effectiveness. Unweighted N=440 148 Intra-Nasal Corticosteroids Wear Off Over Time 100% 80% 60% 55% 54% 54% Primary Care Nurse Prac./Physician Asst Yes 50% 40% 20% 0% ENT Allergist Q27a. Have you ever found that the effectiveness of intra-nasal corticosteroid products in treating nasal allergy symptoms wears off over time, even when taking the medicine as prescribed? N=400 149 Time Until Intra-nasal Corticosteroids Wear Off Nurse Prac./Physician Asst. 26% Primary care 17% Allergist 4% 11% 26% ENT 16% 0% 48% 54% 16% 36% 7% 56% 20% 40% Hours 60% Days 80% 100% Weeks Q27b. About how long after the patient starts taking an intra-nasal corticosteroid does its effectiveness for allergy symptoms begin wearing off, even when being taken as prescribed? Base: Effectiveness wears off N=213 150 Side Effects of Intranasal Corticosteroids Drowsiness 6% 5% 1% 2% 2% Headaches 18% 20% Drying feeling 10% 19% 45% 42% 38% 34% Dripping down throat Nurse Prac./Physician Asst. 13% 12% Burning Primary care 4% 3% Allergist 31% 20% Bad taste ENT 5% 20% 0% 20% 40% 60% 80% 100% Q28. How many of the intranasal corticosteroids for nasal allergies have the following types of side effects – all, most, 151 some, few or none? N=400 Patients Avoid Any Intra-Nasal Corticosteroids 100% 80% Yes 60% 40% 35% 31% 24% 18% 20% 0% ENT Q29a. Allergist Primary Care Nurse Prac./Physician Asst Are there any intranasal corticosteroid medications for nasal allergies that your patients try to avoid using? N=400 152 Reasons Avoid Intranasal Corticosteroids by Specialty Other 8% Don't understand/fear 2% Don't like it/causes discomfort 2% Bad experience 2% Absorbs into system 2% Drowsiness/sleepy/tired/fatigue 2% Not covered by insurance 3% Steroids 3% Headaches 3% Dripping down throat Medication only mentioned Don't work 4% 5% 6% Price/cost 7% Drying/Dried out 7% Spray up nose Side effects (not specified) Burning/stinging Nosebleeds 10% 13% 15% 19% Smell/bad odor or smell/Taste 0% 36% 20% 40% 60% 80% 100% 153 Q29b. Why do your patients try to avoid that/those product(s)? N=108 Satisfaction of Patients with Intra-nasal Corticosteroids Patients 34% 38% Nurse Prac./Physician Asst. 41% Primary care 41% Allergist 55% 57% 39% ENT 61% 42% 0% 20% 54% 40% Very satisfied 60% 80% 100% Somewhat satisfied Q36. In general, how satisfied are your allergic rhinitis patients with their intra-nasal corticosteroids? Would you say that they are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied? N=400 PQ70b. In general, how satisfied have you been with the prescription nasal spray you have used for your nasal allergies in the past? Base: Ever used Rx nasal spray for nasal allergies. Unweighted N=2,033 154 Patients Avoid Using Intra-Nasal Corticosteroids for Nasal Allergies 100% 80% Yes 60% 55% 41% 40% 40% 42% 20% 0% ENT Allergist Primary Care Nurse Prac./Physician Asst 155 Q37a. Do patients avoid using intra-nasal corticosteroids for their nasal allergies? N=400 Reasons Avoid Intra-nasal Corticosteroids 8% Don't like sprays 45% 9% Side effects 30% 29% 29% 10% Safety 20% 57% 55% 54% 40% 30% 29% 1% Nosebleeds 15% 18% 22% 2% Other side effects 2% 5% 11% 2% Not effective 10% 2% No insurance coverage/cost too much 7% 6% 5% 8% 4% 2% 1% Taste/smell 8% 2% 0% 5% Patients Nurse Prac./Physician Asst. Primary care Allergist ENT 12% 20% 40% 60% 80% Why do they avoid using intra-nasal corticosteroids for their nasal allergies? Base: Avoid using intra-nasal corticosteroids for nasal allergies N=178 PQ71. Why haven’t you used a prescription nasal spray you take/took for nasal allergies in the past 4 weeks? Base: Used in past but not past 4 weeks. Unweighted N=1,156 100% Q37b. 156 Reasons Avoid Intra-nasal Corticosteroids (cont.) 4% 5% Other 4% 2% 5% 3% 2% Don't give immediate relief 7% Timing/frequency of use 2% Too drying 4% 2% 11% Not bad enough 3% 4% 2% 2% 2% Don't tolerate well 5% 30% No symptoms 4% 1% Hard to use Patients Nurse Prac./Physician Asst. Primary care Allergist ENT 5% 1% Dependence worry 2% 0% 20% 40% 60% 80% Q37b. Why do they avoid using intra-nasal corticosteroids for their nasal allergies? Base: Avoid using intra-nasal corticosteroids for nasal allergies N=178 PQ71. Why haven’t you used a prescription nasal spray you take/took for nasal allergies in the past 4 weeks? Base: Used in past but not past 4 weeks. Unweighted N=1,156 100% 157 Number of Symptoms Relieved for Success Patients 33% 53% Nurse Prac./Physician Asst. 7% 76% Primary care 6% 78% Allergist 6% ENT 75% 4% 0% 76% 20% 40% All 60% 80% 100% Most Q40. How many symptoms would an intranasal corticosteroid have to relieve for you to consider it a successful treatment – all, most, some, a few or none? N=400 PQ101. How many symptoms would a nasal allergy medicine have to relieve for you to consider it a successful treatment --- all, most, some, a few or none? Unweighted N=2,500 158 Percent Symptom Relief for Success 100% 85% Mean 80% 77% 72% 73% ENT Allergist 71% 60% 40% 20% 0% Q41. PQ102. Primary care Nurse Prac./Physician Asst. On a scale of 0 to 100 percent, what percent symptom relief would you expect from an intra-nasal corticosteroid for it to be considered a successful treatment? N=400 On a scale of 0 to 100 percent, what percent symptom relief would you expect from a nasal allergy medicine for it to be considered a successful treatment? Unweighted N=2,500 Patients 159 How Quick Symptom Relief for Success Mean number of hours 70 60 59 58 54 49 50 40 30 20 10 0 ENT Allergist Primary care Nurse Prac./Physician Asst. Q42. How quickly after taking would an intra-nasal corticosteroid have to begin relieving symptoms for you to consider it a successful treatment? N=400 160 Time Intra-nasals Last for Success Wanting 24-hours or longer (%) 100% 80% 73% 62% 61% 60% 54% 40% 20% 0% ENT Allergist Primary care Nurse Prac./Physician Asst. Q43. How long after taking a dose of intra-nasal corticosteroid should symptom relief last for you to consider it a successful treatment? N=400 161 Opinions About Nasal Allergies 64% 58% 55% Nasal allergies can cause sinus infections 56% Nasal allergies can make asthma worse 22% Frequent nasal allergy symptoms can be prevented in most cases There are no truly effective treatments for nasal allergies 38% 1% 1% 3% 2% Q44. 49% 58% Patients Nasal allergies are a serious health problem in the US Nurse Prac./ Physician Asst. Primary care Allergist 40% 35% 44% 55% 59% 0% 73% 70% 78% 82% 45% 15% 28% 24% 30% 25% Even with proper treatment nasal allergies usually cause some lifestyle limitations 77% 79% 20% 40% 60% ENT 71% 80% 100% Now I am going to read you a series of statements. As I read each statement, please tell me whether you agree strongly, agree somewhat, disagree somewhat or disagree strongly with the statement. N=400 PQ110. Now I am going to read you a series of statements. As I read each statement , please tell me whether you 162 agree strongly, agree somewhat, disagree somewhat or disagree strongly with the statement. Unweighted N=2,500 Patients Get Monies Worth from Rx Medicines 100% 91% 82% 87% 85% 80% 60% Yes 55% 40% 20% 0% ENT Allergist Primary care Nurse Prac./ Physician Asst. Patients Overall, do your patients feel they get their money’s worth out of prescription medicines for nasal allergies? N=400 PQ97. Overall, do you feel that patients get their money’s worth out of prescription medicines for nasal allergies? Unweighted N=2,500 Q30. 163 Need for Better Education of Patients Patients 49% Nurse Prac./Physician Asst. 40% 57% Primary care 43% 52% Allergist 43% 61% ENT 37% 57% 0% 20% 38% 40% Strong need 60% 80% 100% Moderate need Q45. How much need do you think there is for better education of PEOPLE WITH NASAL ALLERGIES about their condition and its treatment? Do you think there is a… N=400 PQ113. How much need do you think there is for better education of people with nasal allergies about their condition and its treatment? Unweighted N=2,500 164 Aware of Professional Guidelines 100% 88% 80% 64% 62% Yes 60% 46% 40% 20% 0% ENT Allergist Primary care Nurse Prac./ Physician Asst. 165 Q46a. Are you aware of any professional guidelines for the diagnosis and management of allergic rhinitis? N=400 Publisher of Guidelines 13% 20% ACAAI 40% 15% 11% 28% AAAAI 57% 56% 3% 4% Joint task force 22% 3% AAOA 2% 21% 13% 11% Other medical society 3% 16% ERS 2% Nurse Prac./Physician Asst. 3% 2% AMA Primary care Allergist 5% ALA ENT 1% 0% 20% 40% 60% 80% 100% 166 Q46b. Who publishes those guidelines? Base: Aware of Guidelines N=260 Publisher of Guidelines (cont.) 39% 33% Don't know 7% 13% 9% 2% Other ARIA 3% 5% Medical journal 2% 2% 2% 2% AAA 2% 2% NIH 6% 2% 2% 3% WHO Nurse Prac./Physician Asst. Primary care Allergist NHLBI ENT 2% 0% 20% 40% Q46b. Who publishes those guidelines? Base: Aware of Guidelines N=260 60% 80% 100% 167 Graduation Year Nurse Prac./Physician Asst. 3% Primary care 25% 29% 21% Allergist 28% 37% 20% 16% 36% 27% 0% 40% 1950 to 1975 1986 to 1995 D1. 35% 42% ENT 43% 15% 22% 60% 80% 6% 14% 100% 1976 to 1985 1996 or later In what year did you [DOCTOR VER: graduate from Medical or Osteopathic school] [NP/PH VER: receive your license as a physician assistant]? N=400 168 Continuing Medical Education 100% 95% 99% 92% 79% 80% Yes 60% 40% 20% 0% ENT Allergist Primary care Nurse Prac./Physician Asst. D2. Have you taken any continuing medical education (CME) courses related to the management and treatment of allergic rhinitis [DOCTOR VER: since medical school] [PA/NP VER: since receiving your license]? N=400 169 Primary Practice Location Nurse Prac./Physician Asst. 33% Primary care 22% Allergist 23% 42% 29% ENT 6% 14% 18% 10% 54% 35% 0% 20% 13% 37% 20% 40% Central city Suburb 12% 21% 60% Small city 80% Town 3% 1% 6% 1% 100% Rural 170 D3. Is your primary practice located in a central city, a suburb, a small city, a town or a rural area? N=400 Gender Nurse Prac./Physician Asst. 21% 79% Primary care 75% 25% Allergist 76% 24% ENT 86% 0% 20% 40% Male 14% 60% 80% 100% Female 171 D4. Gender N=400