Rethinking once-daily dosing on allergy medications

Ideally, an ocular allergy medication should provide clinically significant improvements of the annoying or even incapacitating ocular itch with minimal dosing. While this is a desirable goal, it leads to challenges of the amount of dosing to achieve this objective and patient compliance with such dosing.

How critical is it to effectively treat the ocular itch in our allergy patients? Several recent studies have shown this goal is very important.

Some 500 healthcare providers from seven different specialties were interviewed about their allergy patients and what symptoms led these patients to seek medical care. These providers revealed the number one reason these patients sought their care was because of ocular itch. This symptom of ocular itch was even more troublesome to these patients than nasal congestion and runny nose.¹ This means that the treatment of ocular itch as effectively as possible must become our primary goal.

Related: How to improve diagnosis and treatment of allergy

Diagnosing ocular itch

But to treat the ocular itch of allergies, we must first successfully make the diagnosis. And to make this diagnosis we must interview our patients during their eye examination, or they will be diagnosed and treated by other healthcare providers. A key reason this happens is because our patients rarely present for their routine eye examinations with signs or symptoms of ocular allergies.

But by asking a few “ever” questions such as, “Do your eyes ever itch?” or “Do you ever have allergies and take allergy medications?” we can quickly learn if this patient needs further questioning involving ocular allergies. This additional discussion will then lead to a better understanding if this patient ever has ocular allergies. We can then proactively prescribe for this patient-preventing him from self-treating or seeking another healthcare provider when allergy symptoms arise.

We have learned from glaucoma treatment that more dosing leads to lower compliance.² Of course, glaucoma medication does not treat annoying symptoms such as itch, but nevertheless, a lesson can be learned from this information. Patients have the best of intentions and want to comply with treatment, but “life gets in the way.” This implies an allergy drop that is to be administered twice a day will likely be dosed once in the morning, and due to today’s hectic lifestyle, be dosed again in the late afternoon only if symptoms become intolerable. Obviously this creates a less-than-ideal situation in which the patient does not obtain maximum therapeutic benefit.

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