The Possibility of Using CARAT Questionnaire for Screening of Allergic Rhinitis and Asthma

Purpose: introduction in daily practice to doctors of primary and secondary link of delivery of health care the test control of allergic rhinitis and asthma (CARAT). Materials and methods of research. At a stage of screening by the family doctor, we distributed 29 questionnaires to patients aged from 12 till 18 years which were passive smokers or had: - The family anamnesis burdened by an atopia; - The relapsing broncho-obstructive syndrome; - Frequent and long rhinosinusitis (>3 weeks); - Eosinophilia (< 20%) at the carried-out dehelminthization; Parents of respondents asked not to help patients with answers. Irrespective of result of the questionnaire, all respondents were examined by the allergist for confirmation or a denial of the possible diagnosis of respiratory allergoz. For each patient allergologic history was collected and physical examination was carried out. Also to each child skin prik-tests with mixed allergens pollen No. 1,2,3,4 and mixed allergen household No. 5 by means of lancets for the rotational prik-test of 1 type of “Immunology” firm were made. During other part of research, the treating allergolog distributed 40 questionnaires to patients at the age of 12-18 years, with already established diagnosis of allergic rhinitis and/or bronchial asthma. At repeated visit (in 3 months), 34 patients who strictly adhered to appointments, physical examination and repeated re-survey of CARAT was conducted. Results and discussion. At the first stage from 29 patients directed to the allergist two (7%) were found with the positive test for allergic rhinitis and asthma (CARAT). But only at one the sensitization to household allergens was confirmed and the diagnosis allergic year-round rhinitis is established. In the others 27 (93%) patients, with negative skin tests and the negative CARAT test, it wasn't revealed signs respiratory to an allergoz. Consultation of adjacent experts for continuation of diagnostic search was recommended to these patients. At the second investigation phase, during the next survey the allergist, the following results were received: - 11 (32%) from 34 patients subjectively estimated the condition showed results of a questionnaire better. From what we can draw a conclusion that patients got used to a new way of life with an illness and expedient will compare quality of life of the patient in dynamics, but not in comparison with the healthy person. - 7 (20%) patients had to a bronchial asthma and had manifestations of year-round allergic rhinitis which needed additional treatment, with taking into consideration the fact that rhinitis can disturb full control of bronchial asthma. - In 14 (41%) respondents - results of the second survey significantly (more than 3 points) differed from the first that caused correction of basic therapy. Conclusions. Thus, CARAT: Gives one more opportunity of control of the course of respiratory allergoz and selection of an adequate dose and frequency rate of drug intake; At patients with bronchial asthma and the accompanying allergic rhinitis beforehand reminds about need of monitoring or even treatment of the accompanying allergic rhinitis; Improves compliance and building of partnerships "patient - doctor"; Gives the chance quickly and cheap to help with screening of respiratory allergoz at an initial stage of delivery of health care as shows high reliability of results (93%). Prospects for further research. At the moment in Ukraine other questionnaires which help to control the course of bronchial asthma or allergic rhinitis and bronchial asthma at the same time are registered. Therefore the purpose of further researches is to compare these questionnaires from CARAT profiles and identification of that that gives the most probable results, it is available and clear for children and fast in filling.