Shared decision making in allergic rhinitis: An approach to the patient

Objective: To review what is known about the importance of shared decision making (SDM) in allergic rhinitis.

Data sources: MEDLINE and PubMed database searches for SDM, patient preferences, patient motivation with mobile apps, over-the-counter medications, adherence, complementary and alternative therapies, nasal steroids, and immunotherapy.

Study selections: No articles directly dealt with the effects of SDM on outcomes in allergic rhinitis. Thus, of the 77 articles produced by these searches, 41 were selected based on the information relevant to evaluating the need for SDM in these patients.

Results: Poorly controlled allergic rhinitis continues to be associated with substantial morbidity. Complicating the effective control of the disease is the tendency of patients to self-manage using information from a variety of sources other than health care providers. Although direct evidence in allergic rhinitis is lacking, controlled trials have found the benefits of SDM in improving adherence and outcomes in at least 50 other disease states. Thus, this review explores the aspects of the disease that are complicated by poor adherence, establishing the case for the need for widespread use of SDM techniques.

Conclusion: Patients are confronted with a complex array of treatment options for allergic rhinitis, and a consistent SDM approach can better equip them to make the requisite care decisions needed to achieve optimal control. Furthermore, improving patient education through SDM provides a framework that enables long-term adherence for maximal outcomes.