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The information about Japanese cedar pollinosis (JCP) from the Internet is growing these days. We examined the effects of the pollen information on people who have JCP.We conducted web research from 2003 to 2006 between February 1st and April 30th on a pharmaceutical company's website.On a gender basis, women tended to seek information about JCP more than men did. Furthermore, women consulted a doctor when the amount of pollen was large, while men didn't. People who made wide use of the pollen information had a behavioral tendency to seek consultation and performed many kinds of self-care for their own disease.The information for JCP using the website has enormous effects on people's lives. We should give more meaningful information and patients should take more as well.

It is reported that the health-related quality of life (HRQL) is an important outcome in the Japanese Cedar Pollinosis (JCP) treatment. In Japan, the disease-specific Japan Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ) and the generic SF-36 Health Survey (SF-36) has been used. The aim of this study is to investigate more profitable QOL by using both the disease-specific questionnaire and the non-disease-specific questionnaire together.411 patients with JCP who visited 10 ENT clinics in Osaka from March 14 to March 26 (peak pollen season) in 2005 were questioned, and 240 patients were engaged in this study as subjects. In this study, the QOL scores were evaluated using the JRQLQ and SF-8 Health Survey (Japanese Version), a new, even shorter generic health survey.Using factor analysis and the correlation matrix, we showed that the disease-specific and the general health instrument covered a different half the total measurable HRQL. There was some correlation between the SF-8 items with the JRQLQ domains. There was little correlation between the SF-8 items and symptom scores, while, there was high correlation between the JRQLQ and symptom scores. The "Usual daily activities" domain in the JRQLQ correlated with any rhinoconjunctivitis symptoms.Both JRQLQ and SF-8 can be used to assess the quality of life of patients with JCP. Each instrument measures the aspects of the HRQL that hardly overlaps. For an assessment of the HRQL in JCP that is complete and responsive both instruments should be employed together.

Recently, the number of patient with Japanese cedar pollinosis (JCP) has been increasing. In the last 3 years, the amount of pollen has been very volatile. In this study, we examined that whether the amount of pollen influenced symptoms and selfcare using web site.For this examination, the questionnaire on web site was used from March 15 to April 30, 2003, 2004, and 2005 respectively.The rate of early treatments was high in the years when the amount of pollen was large, while the rate was low in the years when the amount of pollen was little. In the comparison of symptoms, the severity of the symptoms, in particular, nasal congestion, itchy eyes, watering eyes, and disturbance of sleep, was highly related to the amount of pollen. In addition, these symptoms were the severest in 2005. And the selfcare was also changing according to the amount of pollen.We concluded the greater the amount of pollen was, the severer the nasal congestion, eye symptoms, and disturbance of sleep were. The questionnaire survey that uses web site is a limited investigation of patient who has the access to the Internet. However, in the trend survey of JCP patients, it seemed that was extremely meaningful.

The number of patients with Japanese cedar pollinosis (JCP) is increasing, and now, has extended up to about 15% of the Japanese. It is reported that the QOL is an important outcome in the JCP treatment. This study aimed to evaluate the QOL in patients with JCP by means of the SF-8 Health Survey (Japanese Version), a new, even shorter generic health survey.411 patients with JCP who visited 10 ENT clinics in Osaka from March 14 to March 26 (peak pollen season) were questioned, and 204 patients without any treatments in this season were engaged in this study as subjects. In this study, the QOL scores were evaluated using the SF-8. This is an 8-item version of the SF-36 that yields a comparable 8-dimension health profile and comparable estimates of summary scores for the physical and mental components of health.The QOL score depressed in the patients with JCP compared with healthy subjects (Japanese national norms). Both Mental Component Score (MCS) and Physical Component Score (PCS) scores decreased more in females than in males. In females, MCS were significantly lower than national norms. The older the patients were, the lower PCS scores were showed. The severity of nasal symptoms influenced the PCS scores.These results showed the tendency similar to the early studies using SF-36 questionnaire. The sensitivity of SF-8 in the individual is not better than that of other specific QOL questionnaires, but SF-8 can be answered in a short time compared with other questionnaires including SF-36. We suggested that SF-8 become a useful questionnaire in the future.

Allergic rhinitis can interfere with cognitive function, can impair work productivity, and may cause work absences. In this study, we evaluated the impact of Japanese cedar pollinosis (JCP) on work productivity.The study was conducted between February 24 and March 8, 2003 (peak pollen season), and 512 workers with JCP were enrolled. Study outcomes included self-reported work productivity (absenteeism and presenteeism) and quality of life (the Medical Outcomes Study Short Form-36).Most patients (91%) did not lose their work time due to JCP during the past 7 days. Approximately half of patients reported a 25% reduction in productivity compared with non pollination season. In multiple logistic regression analysis, the following factors were selected as independent risk factors for lost work time: duration of disease (adjusted odds ratio (aOR) = 0.658) and itching eyes (aOR = 1.552). Likewise, SF-36 PCS (aOR = 0.946), MCS (aOR = 0.927) and using pollinosis relief products (aOR = 2.020) were predictors of lost productivity.This study shows that we should pay more attention to ocular symptoms as well as nasal symptoms and improve patients' quality of life as soon as possible in order to reduce productivity losses.

There is little information about the relationship between local pollen counts and pollinosis symptoms of the local patients. In this study, we compared patient-reported outcomes (PROs) of Japanese cedar pollinosis (JCP) according to regions.The study was conducted between February 24 and March 8, 2003 (peak pollen season), and 1200 patients were recruited from 15 ENT clinical sites in 4 regions : central Osaka (n = 576), southern Osaka (n = 195), northern Wakayama (n = 234), and southern Wakayama (n = 195). PROs consisted of nasal symptoms, ocular symptom, learning and work impairment, and QOL (SF-36).In non-treatment group, there were significant differences in ocular symptom and learning and work impairment among regions. On the other hand, patients with longer duration of treatment had better symptom relief regardless of pollen level in early treatment group. As to QOL, SF-36 summary scores did not differ among regions in both groups.This study shows that patients without early treatment seemed to be affected by pollen level on their ocular symptom and its related outcomes. In patients with early treatment, however, the treatment duration had bigger impact on PROs than the local pollen counts.

Japanese cedar pollinosis (JCP) affects more than 16% of the Japanese population. The estimated direct and indirect costs for this disease totaled 286 billion yen in 1998. In JCP therapy, antihistamines are first line agents. It is well known that starting treatment for JCP with antihistamines before initial day of the pollen scattering can relieve nasal symptom severity during pollen season. The aim of this study is to assess the clinical efficacy and cost-quality of 7 major second-generation antihistamines in early treatment for Japanese cedar pollinosis (JCP).Patients were randomly selected from 16 ENT clinical sites in Osaka and Wakayama between February 24 and March 8, 2003 (peak pollen season). Effectiveness was assessed using patient'ratings of nasal and ocular symptoms and overall assessment in their condition compared to previous season ones. Costs include direct costs of the drugs used for treatment to JCP from January to March.One hundred seventy-five patients who were treated with antihistamine monotherapy (azelastine: n=15, cetirizine: n=15, ebastine: n=36, epinastine: n=16, fexofenadine: n=16, loratadine: n=60, oxatomide: n=17) and 510 non-treatment patients were evaluated. Among 8 groups, there were significant differences in sneezing, rhinorrhea, ocular itching and overall health condition. However, among 7 monotherapy groups, there were no differences in each symptom or the overall assessment. In cost-quality analysis, there were significant differences in a cost for each effective patient (defined as those with improvement in their overall condition) among 7 drugs. The top three cost-efficacious drugs resulted in azelastine, loratadine and fexofenadine.These results show that there were no significant differences in clinical efficacy in early treatment for JCP among 7 antihistamines. But Japanese National Health Insurance drug price scheme led to significant differences in cost-quality.

Recently the number of patient with Japanese cedar pollinosis is increasing. We think many patients are not consulted by a doctor, therefore the questionnaire survey only at hospitals is not enough to know patient's trend. In this study, we examined the trend of patients with pollinosis by the use of a web site.For this examination, questionnaire on web site was used from February 1 to April 30, 2003. In this time, the correlation between the pollen counts and access number, how to collect information of pollinosis and the presence of early treatment were focused.The access number to the web site was 348,045 and 1,612 patients answered the questionnaire. There was a good correlation between Japanese cedar pollen counts and the access number to the web site. Most patients (61.2%) collected information about pollinosis and pollen counts by television/radio as well as internet. Patients under 40 years had a medical consultation after the onset symptoms of pollinosis, on the other hand patients over 40 years had a medical consultation before the onset symptoms of pollinosis. Patients who lived in east Japan had a medical consultation before the onset of pollinosis and lived in west Japan after having symptoms.It concluded that age and area of patients influenced the patient's trends. Nowadays the spread of internet is remarkable. Therefore, the reliable presentation of information of pollinosis through internet become more important.

Drug adherence is one of the important aspects in caring for patients with allergic rhinitis. To improve clinical efficacy of early treatment for Japanese cedar pollinosis (JCP), we evaluated the effect of drug adherence on patients' outcomes. Patients were randomly selected from 16 ENT clinical sites in Osaka and Wakayama between February 24 and March 8, 2003 (peak pollen season). Efficacy was assessed using patients' ratings of nasal and ocular symptoms and overall assessment in their condition compared with previous season ones. Costs include direct costs of the drugs used for treatment to JCP from January to February. Five hundred one patients taking early treatment were enrolled. Compared to low adherence patients, those who reported higher level of adherence significantly improved overall health condition, and achieved better symptom relief of rhinorrhea and nasal congestion. In multiple logistic regression analysis, the following factors were independent risk factors for low adherence: student (p=0.002), using OTC medications (p=0.006), and short-duration of medication (p=0.001). Low costs were also risk factor for low adherence. We conclude that taking medications for JCP for 22-28 days is the best way to enhance patients' outcomes.

Allergic rhinitis is not fatal illness, but its high prevalence and several symptoms result in substantial medical cost. There is increasing interest in the use of economic evaluations in healthcare; therefore, we investigated patients' willingness to pay (WTP) for prevention and cure from Japanese cedar pollinosis (JCP), and compared WTP values assessed in non-pollination season (June 1998) and pollination season (February-March 2003). Japanese economic woes got worse in 2003 than in 1998. Patients were randomly selected from ENT clinical sites in Osaka, 175 and 645 patients completed WTP questionnaire in 1998 and 2003, respectively. WTP value was lower in 2003 than in 1998, which related to part-time employees and housewives' reducing WTP. Declining WTP value did not associated with the differences in patient characteristics between 1998 and 2003 including age, duration of disease, nasal symptom severity and comorbid condition. These results show that we have to take employment status into account in economic evaluations. Decline in WTP for JCP in 2003 was strongly affected by Japanese sluggish economy, and the WTP seemed to be stable value in individual patients.

For patients with pollinosis, self-care is important as well as medical care. In this study, we investigated the real situation of patients with pollinosis-how they manage their symptoms. A questionnaire-based examination was conducted among 488 patients who visited National Osaka-Minami hospital and Sano ENT clinic. The onset of pollen dispersion occurred 17th Feb. 34.6% of patients visited before the onset of pollen dispersion. 45.5% of them had a checkup for allergens. 84.8% of them utilized pollen information. 41.4% of them did self-care. The rate of patients who utilized pollen information and did self-care was higher in female compared with male. The rate of those who did self-care was significantly higher in the patients who visited before pollen dispersion, who had a checkup for allergens, who utilized pollen information, compared with the patients did not. It is necessary to show the information of self-care as well as pollen, and suggest the importance of self-care against pollen allergens.

Seasonal allergic rhinitis (SAR) is one of the world's most common health problems because it's a high-cost, high-prevalence disease. In this study, we investigated patients' willingness to pay (WTP) for prevention and cure from most common SAR, Japanese-cedar pollinosis. Two hundred and forty patients with Japanese-cedar pollinosis, who visited 4 clinics in Osaka and were measured QOL by the SF-36 Questionnaire (Japanese version) during pollen season, were mailed WTP questionnaire in off-season in 1998. Completed questionnaires were sent back by 175 patients. Most patients (83.5%) were willing to pay less than 10,000 yen. Patients with longer duration of disease or severer nasal symptom tended to be more willing to pay. In contrast, no association was found between WTP and sex, age, occupation and comorbid condition. There were significant impairments in five of eight QOL dimensions in patients of Much-WTP in comparison with Less-WTP. Patients with mild symptom had significant higher medication cost than those with less mild symptom. We conclude that effective treatment, even if it costs much, can satisfy patients and may help to reduce indirect costs as well as to lessen the impact of Japanese-cedar pollinosis on QOL for both patient and society.

Atopic dermatitis is a common skin disorder with an age onset mainly from infancy to adolescence. Patients with this disorder usually have a long history of repeated relief and relapse. The aim of the present studies is to quantify the relationship between the QOL score of patients and symptomatic characteristics (including severity measured by SF-36). From November 2000 to February 2001, the study recruited 281 patients with atopic dermatitis who had been treated at the Nagano dermatology and allergology clinic. The results of this study demonstrated that the symptoms severity and pruritus grade had strong influences on QOL score, and the location of pruritic lesion on the neck had the strongest influence on their self-perceived health status. The patients group with moderate atopic dermatitis who showed pruritus lesion in face, neck, and or knee, and female had consistently lower scores than male on all of the subscales. In conclusion, it is critically important to control of pruritus, and to develop an appropriate management.