Allergic rhinitis in children in Dutch general practice in 1987 and 2001.

Introduction: Allergic rhinitis is a common chronic disorder in children, mostly diagnosed in primary health care. This study investigated the national incidence and treatment of allergic rhinitis among children aged 0-17 years in Dutch general practice in 1987 and 2001 to establich whether changes have occurred. Materials & methods: a comparison was made with data from the first (1987) and second (2001) Dutch National Surveys of General Practice on children aged 0-17 years. The management of the general practitioner was assessed regarding drug prescriptions and referrals to medical specialists, and compared with the clinical guideline issue in 1996. Results: the incidence rate of allergic rhinitis increased from 6.6 (1987) to 9.2 (2001) per 1000 person-years. We found a male predominance with a switch in adolescence to a female prodominance at both time points. Compared to 1987, there was a significant increase in incidence in the central part of the Netherlands in 2001. In 2001, children of natives and western immigrants visited the general practitioner more often with complaints of allergic rhinitis compared to 1987. In 1987 prescribed medication consisted mainly of nasal corticosterioids (36%) and in 2001 of oral antihistamines (45%). Overall, the treatment of allergic rhinits was in both years in accordance with te current clinical guideline, but with a stroger adherence in 2001. Conclusion: The results show an increased incidence in the past decades of allergic rhinits in children. The shift to a smaller spectrum of prescriptions in 2001 may be a result of the 1996 clinical guideline