npj Primary Care Respiratory Medicine· 2026Q1· Review
Allergic rhinitis in primary care: Navigating diagnostic uncertainty, treatment failure and referral
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- Q1SCImago
- 2026year
Short summary
Primary care clinicians can use a decision sequence to manage allergic rhinitis, distinguishing clinically relevant allergy from other conditions and optimizing treatment and referral to reduce unnecessary testing and delays.
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Key points
- Distinguish clinically relevant allergic rhinitis from sensitization, nonallergic rhinitis, chronic rhinosinusitis, and structural disease.
- Determine when a clinical diagnosis is sufficient versus when allergen-specific testing (skin-prick or serum IgE) is indicated.
- Optimize intranasal treatment strategies and assess adherence or technique issues in apparent treatment failures.
- Differentiate between allergy/immunology and otolaryngology referral pathways.
AI-generated from the title and abstract; the full text is not read.
Abstract
Abstract Allergic rhinitis is usually first recognised and treated in primary care, where decisions often precede allergen testing or specialist assessment. The challenge is not simply identifying classic allergic symptoms, but distinguishing clinically relevant allergy from sensitisation, nonallergic rhinitis, chronic rhinosinusitis and structural disease; selecting treatment according to burden; and recognising when apparent treatment failure reflects poor adherence, incorrect intranasal spray technique or an alternative diagnosis. This practice-oriented Review translates current guideline and consensus evidence into a decision sequence for first-contact care. It focuses on when a clinical diagnosis is sufficient, when targeted skin-prick or serum allergen-specific IgE testing will change management, how to optimise intranasal treatment, and how to separate allergy/immunology from otolaryngology referral pathways. The aim is to reduce indiscriminate testing, unnecessary treatment escalation and delayed referral while preserving the longitudinal advantages of primary care.
The authors' abstract, as published at the source. npj Primary Care Respiratory Medicine, 2026 · DOI ↗
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Field: Immunology and Allergy
Immunology and AllergyMedicine