5.9.1. Introduction

Asthma is a chronic, inflammatory condition of the airways characterized by airway hyper responsiveness and episodic, reversible, respiratory symptoms (Holgate et al, 2006).

Allergic rhinitis (AR) is clinically defined as a symptomatic disorder of the nose induced after allergen exposure. Symptoms of allergic rhinitis are reversible either spontaneously or following treatment. AR is associated with impairments in patients functioning in day-to-day life affecting sleep and emotions, as well as impairment in activities and social functioning (Skoner, 2001).

Asthma is estimated to affect approximately 4–11% of the general population while AR is estimated to affect 10–30%. Asthma and AR are often co-morbid diseases to such an extent that the prevalence of AR among asthmatic patients is usually over 50%. In addition to the symptomatic burden of AR in patients with asthma, AR can complicate asthma management and result in poorer asthma outcomes. As a result, asthma-related medical resource usage may increase in patients with asthma and concomitant AR compared to those with asthma alone (Braido et al, 2007). Therefore, an optimal management of rhinitis may improve coexisting asthma and vice versa; thus a combined diagnostic and treatment strategy should be used to approach these two conditions.

Different studies, such as the European Community Respiratory Health Survey (ECRHS) and the International Study of Asthma and Allergies in Childhood (ISAAC), have reported several data on the prevalence of both allergic asthma and rhinitis althought comparisons are difficult due to the technical characteristics of the studies. Nevertheless, the epidemiology of allergic disorders has recently gained great attention as the prevalence of asthma is on a steady increase (Holgate et al, 2006). Changes in diagnostic sensitivity and in reporting attitude can only partially explain these increasing trends, which have been attributed mainly to changes in exposure to environmental risk factors and to the so-called western lifestyle (Kim et al, 2003).

In addition to the economic burden of asthma, which is considerable, there are physical, emotional, and social effects, leading to a reduced quality of life (QoL) of both patients and their families. For most asthmatic patients, the disease has a deep negative impact on daily life (Baiardini et al, 2006).

Understanding asthmatic patients needs and behaviours is fundamental for developing an asthma-related healthcare policy.