Standardized training for healthcare professionals and its impact on patients with perennial rhinitis: a multi-centre randomized controlled trial

Abstract

Background Perennial rhinitis is common and often results in substantial, potentially avoidable, impairment of quality of life. Quality of rhinitis care has been shown to be sub‐optimal in general practice. Rigorous evaluation of educational interventions for healthcare professionals using randomized controlled trials is very uncommon. Objective To evaluate the effectiveness of standardized allergy training for healthcare professionals on patients' disease‐specific quality of life. Methods Patients with clinician diagnosed perennial rhinitis and/or a prescription for relevant nasal medication were recruited from general practice. Following baseline measurement of quality of life using the validated rhino‐conjunctivitis questionnaire (RQLQ), patients were centrally randomized to receive care from an allergy‐trained primary healthcare professional or routine care. RQLQ was measured again at 13 months after randomization. Results Process measures revealed that the training was well received. 202 patients were included in the intention‐to‐treat analysis and 157 in the per‐protocol analysis. There was a 0.23 greater mean improvement in quality‐of‐life scores in the intervention group when compared with controls (P=0.08) in the intention‐to‐treat analysis, this increasing to a 0.3 greater mean improvement if confined to a per‐protocol analysis (P=0.05). The intention‐to‐treat analysis showed that 39/101 (39%) in the intervention group showed a clinically significant 0.5 improvement in RQLQ compared with 28/101 (28%) of controls (risk difference=11%, number needed to treat=9, P=0.1). Conclusions Standardized allergy education given to primary healthcare professionals leads to modest improvements in disease‐specific quality of life in patients with perennial rhinitis.