Allergic Rhinitis Improvement through Strategic Education: The ARISE Trial

Participants will be recruited following standard consultations with their regular treating clinician and confirmation of moderate to severe allergic rhinitis diagnosis and a positive Skin Prick Test (SPT) to at least one environmental allergen. The treating clinician will provide patients with a recommendation/ prescription (if required) for Combination Intra-nasal corticosteroids and Intranasal antihistamine spray (INCS/INAH) and the minimum standard of care education including demonstration of correct INCS/INAH application technique and a personalised Australasian Society of Clinical Immunology and Allergy (ASCIA) Allergic Rhinitis (AR) Treatment Plan. Post confirmation of AR diagnosis, the treating clinician will inform their patient about the study. If patients are interested in participating or wish to know more, they can register their expression of interest (EOI) via an online webform accessed via a QR code located on the flyer they are given by their treating clinician. Following submission of an EOI form an SMS message will be sent to the participant, providing them with a bookings link so they can select their preferred time of the video telehealth call. with a study team member. In addition, a copy of the Participant Information Consent Form (PICF) will be automatically sent to their nominated email address to allow time for them to read and discuss the study with friends and family. The first telehealth call will be conducted within 3-4 working days after registering to discuss the study, answer any questions, obtain informed consent and complete the enrollment visit. An individual can reschedule their telehealth call if the day and time is not suitable. Participants randomised to the intervention arm will receive an advanced patient education toolkit and reminders delivered by email/SMS in addition to the standard education provided by their treating clinician. After randomisation, the study team will confirm participants received the standard of care education resources at their consult visit with their treating clinician. The study team will re-educate and discuss these educational resources with them. If randomised to the Enhanced Education Package (EEP), the study team will educate on the additional resources and how the repeat reminders will work. Both groups are reminded to continue to see their treating clinician and to attend any appointments they may have. The EEP group will be educated by the study team that will take approximately 30 mins and will contain: • Dosing/frequency – links for the package inserts for Dymista/Ryaltris will be provided and the study team will re-educate participants about the importance of following the dosage and frequency as prescribed by the treating clinician. • INCS/INAH technique – the study team will ask participants to show them the correct technique in taking their nasal spray and provide a link to the ASCIA guidelines for INCS/INAH application. The study team can re-educate the participant until the correct technique is displayed. • ASCIA AR Treatment Plan – the study team will check each participant has been provided with a plan by their treating clinician and go through the plan. If the participant does not understand their plan or needs further information on dosage and frequency, the study team will ask the participant to contact their treating clinician to organise an appointment to be reviewed. The study team will also send a letter to the treating clinician explaining this. • Weekly repeat reminders – these reminders will be sent via either SMS or email over a period of 3 months. They will instruct and remind the participant to take their INCS/INAH as per their treating clinician recommendation and why it is important to take it as instructed. • Education Toolkit – contains links to websites of key organisations including the National Allergy Council (NAC), Allergy & Anaphylaxis Australia (A&AA), Australasian Society of Clinical Immunology and Allergy (ASCIA), National Asthma Council Australia (NACA) and AusPollen which include educational videos and other resources. Participants are not required to complete any education surveys from the education toolkit. The study is measuring the metrics regarding the use of the resources from the clicks and page views through the email distribution system we are using. There is no strategies used to assess adherence.