Allergy is the most common chronic disease in Europe (EAACI, 2015) and Ireland has some of the highest prevalence rates of allergic conditions in the world.
In LloydsPharmacy, sales of medicines for allergies have increased by 10% in the past 2 years. We experienced 35% growth in this category in the summer of 2021 and in 2022 we are trending at a similar level to last summer.
The allergies sector is therefore a key focus within Pharmacy to ensure Pharmacy teams can offer their patients the right knowledge, products and advice to help manage symptoms and improve their quality of life.
Allergy Age Profile
Allergic rhinitis (AR) in the paediatric population is quite high, making it one of the most common chronic paediatric disorders (Akhouri SA, 2020).) • The percentage of children diagnosed with allergic rhinitis and eczema have both trebled over the last 30 years (Gupta R, 2007).
Allergic rhinitis affects between 10% and 30% of all adults and as many as 40% of children (Pawankar et al., 2013) • Allergic conjunctivitis symptoms are present in up to 71% of patients with allergic rhinitis. (Leonardi et al., 2015) • Oral Allergy Syndrome affects almost 46% of Seasonal Allergic Rhinitis sufferers causing itching, tingling, and swelling of lips, tongue, palate and pharynx (IviČeviĆ et al., 2015.
Most common allergens
Almost half (48%) of sufferers have more than one allergy (Mintel, 2010)
• House dust mites – In a European study House Dust Mite (HDM) sensitivity was seen 22% of the study population.
• Grass and tree pollens – In a Survey 21% of allergy sufferers had Hay fever (2018 omnibus 1000x people in Ireland)
• Pet hair or skin flakes – Allergies to dogs and cats affect 10%-20% of the population worldwide and is a growing public health concern as these rates increase (Chan S, 2018)
• Fungal or mould spores
• Food (particularly milk, eggs, wheat, soya, seafood, fruit and nuts)
• Wasp and bee stings
• Certain medications, such as penicillin and aspirin
• Latex
• Household chemicals
Symptoms and Impact on Quality of Life
Research conducted on behalf of LloydsPharmacy by Empathy research with 1000 adults over 18 years old outlined most common symptoms include 76% sneezing, Runny/Blocked nose 72%, Itchy/ watery eyes 71%
Patients with allergies report their symptoms as causing significant daily disruptions to their lives (Canonica et al., 2008):
• 36% experienced puffy eye lids
• 74 % experienced itchy, watery and burning eyes
• 36% experienced a blocked nose
• 70% experienced either a blocked nose, a runny nose or sneezing
• 34% experienced fatigue
• 36% experienced an itchy palate
Everyday activities impacted by allergies
• Sleep disturbance and impact on general mood
• Socialising and especially outdoors during pollen season (April to September)
• Travel plans
• Ability to concentrate for tasks such as reading or reading screens at work
• Ability to exercise outdoors during pollen season
• Sick days from work
How Pharmacy staff can help Patients
Community pharmacists are most often the first port of call for patients with allergy symptoms. Friendly pharmacy colleagues and pharmacists who take the time to engage with the patients, offer some useful practical tips and recommend suitable products to meet their needs can make a real difference to the patient’s quality of life.
A simple WWHAM interview will reveal the patient’s symptoms and the products that they may have tried already as well as any existing medical conditions and current medication. This will allow the pharmacy colleagues to recommend products that will best meet the needs of the patient.
Taking the time to listen to the patient’s past experiences and what products they have previously tried is particularly important. 67% are dissatisfied with current treatment options for allergy. (Werkhauser et al.,2015) and around 40% of patients per hayfever season will switch medications in an effort to find effective relief. (IPN,2020). Some patients may prefer oral medication while others may prefer topical treatments e.g., some of the antihistamines used to treat allergic rhinitis, may produce sedation and for practical reasons, people will wish to avoid such products for daytime use.
Other ways of supporting this patient group and alerting them to the available supports are via:
• Instore information leaflets,
• Advice and practical tips on digital screens (symptoms and treatment)
• Point of Sale displays
Pharmacists will also exercise their professional judgement and will know if the patient needs to be referred to their GP. For example, if a patient with asthma is experiencing shortness of breath, if an allergy rash is particularly aggressive or if the patient has tried multiple products already without any success in achieving relief from their symptoms.
Treatments
• Oral antihistamines are core to the range, across a choice of brands. However, in recent years there has been an increase in choice of nasal and eye products as patients often require more than one treatment.
• New product development from drug free natural remedies has brought a good addition to the category.
• Telfast™ moving to OTC was a major development in the category in 2021.
Engagement with patients to learn more about their lifestyles and the nature and severity of their symptoms will allow pharmacy colleagues to recommend a product or a combination of products that will provide relief and make a real difference to their dayto-day routine.
Tips and Advice to patients for common allergies brought to you by Martin Hynes, Clinical Governance Pharmacist, LloydsPharmacy:
How can you prevent allergies, both inside and outside? Hay Fever:
• Check weather reports/apps for the pollen count and stay indoors if possible, when it is high
• Avoid drying clothes and bed linen outside when the pollen count is high
• Wear wraparound sunglasses
• Shower and change your clothes after being outside
• Avoid grassy areas such as parks and fields, particularly in the early morning, evening or night
• If you have a lawn, ask someone else to mow it for you.
House Dust Mites:
• Choosing wood or hard vinyl floor coverings instead of carpet
• Choosing leather, plastic or vinyl furniture instead of upholstery
• Vacuuming and cleaning soft furnishings regularly
• Use allergy proof-covers on mattresses, pillows, and duvets
• Use a vacuum cleaner with a HEPA filter
• Regularly wipe surface with a damp, clean cloth. Avoid dry dusting as it propels dust through the air.
Pets
• Keep pets outside as much as possible
• Regularly wash and groom pets (outside!)
• Regularly wash and change pets’ bedding
• Don’t allow pets in bedrooms.
View the August IPN magazine here
To recieve the monthly IPN magazine, click here
