Allergies:

The perception by patients about the impact of their disease on daily life correlates poorly with clinical measures of that disease. Therefore, evidence of a patient's quality of life (QoL) cannot be inferred from clinical indices but must be measured directly. With the use of validated questionnaires, QoL becomes an objective assessment which complements the clinical indices of the disease allowing doctors a complete insight into the impairment of patient's life. Read Prof. Elizabeth Juniper opinion about the importance of quality of life in allergic rhinitis.

The evaluation of Quality of Life (QoL) is a way to objectively assess how a patient or a population of patients subjectively feels the impact of the allergic disease on his/her daily life.

It appears more and more essential to take QoL parameters into consideration, as it is the way patients estimate the efficacy of their treatment. Complementary to the doctor efforts mainly focusing on the severity and evolution of symptoms, patients have the feeling that their disease is not limited to their symptomatology. Their experience of the disease is more global, individual and consistent over time than the objective assessment of the clinician. 

To consider quality of life:

• allows a more realistic view of the burden of the disease than considering symptoms alone
• provides a sensitive way to address the usefulness of the treatment
• is obviously important to stimulate patient's compliance to treatment.

Some data of recently published papers are presented in the next pages concerning:

• foodallergy
• respiratory allergy
  • allergic rhinitis
  • asthma
  • conjunctivitis    
• dermatologic allergy
  • chronicurticaria
  • contact dermatitis
  • atopic dermatitis   
• insect venomallergy   

Most of the allergic disorders are not life-threatening and still considered as benign diseases. This can lead to a low rate of consultation by patients, a weak medical follow-up, under-diagnose and under-treatment. The potential evolution towards asthma, the risk of anaphylactic reactions, as well as the severity of their impact on patients daily life, requires a fundamental change in the perception of those diseases, by the public, patients, doctors and health authorities. 

Treatment of allergic diseases must not any more be considered as trivial.

Already, the ARIA new classification¹ of allergic rhinitis suggests to evaluating the severity of the disease according to criteria linked to the patient's quality of life (table 1). Firmly focused on the patient's well-being and the necessity to deal with his/her specific needs, this new type of assessment is expected to better take into account the satisfaction of the patient regarding the efficacy and tolerance of the treatment, and thereby to promote his/her compliance.

For doctors, understanding the patient's perception of the disease is obviously more important for treatment compliance and follow-up than the simple identification of individual symptoms and their progress. QoL measurement helps doctors to remind that the ultimate goal of their intervention is to treat a patient, not only a disease. 

Dr Luc Crasborn