The Pharmacist’s Role in Managing Allergies

Pharmacists can help patients with allergies acquire the right oral antihistamines or decongestants, steroid or decongestant nasal sprays, and/or eye drops based on symptoms.

For many patients, allergy season can be a dreaded time of year. Seasonal allergies affect 10%-30% of Americans on a yearly basis and can cause a plethora of symptoms, ranging from sneezing, runny nose, and itchy, watering eyes to shortness of breath, wheezing, swelling, and rash.

Luckily for these patients, there are many effective treatment options for mild to severe allergies available both OTC and by prescription. In fact, there are so many available treatment options that patients may often need guidance to choose the best products for their symptoms, which is the primary place the pharmacist comes in. There are many places in a patient’s allergy treatment journey where a pharmacist can plan an important role.

To begin, pharmacists are often involved in the management of a patient’s allergies from the very start. Many patients will approach a pharmacist for guidance on making a self-diagnosis based on symptoms.

Because seasonal allergies may affect patients differently year-to-year and even day-to-day, sometimes identifying these symptoms can be nuanced and difficult. Similarly, allergy symptoms often mimic the symptoms of a common cold.

Patients with new seasonal allergies may believe at first that they are suffering from a virus, and though treatment options may overlap in some ways for colds and allergies, correctly identifying the ailment and starting the most appropriate regimen immediately will certainly allow patients to feel better much sooner.

For most of these patients, allergies can be treated completely with OTC medications, requiring no visit to a physician and no prescription. This places pharmacists in a unique and important position for getting allergy patients started on the correct OTC therapies for their symptoms as there are so many products to choose from.

Because pharmacists are the most accessible health care providers and likely the most knowledgeable regarding OTC products, our role here is quite clear. Pharmacists can help patients acquire the right oral antihistamines or decongestants, steroid or decongestant nasal sprays, and/or eye drops based on symptoms.

Pharmacists can also help direct patients to potentially useful and cost-saving combination products that will address the correct symptoms while not overmedicating. Helping patients new to seasonal allergies deal with their symptoms OTC is not the only place a pharmacist plays a significant role in helping patients manage this disease state.

For many patients, OTC treatments will not successfully resolve their symptoms, requiring them to seek further care from either a primary care provider or an allergy specialist. These patients will likely receive prescriptions for rescue and/or steroidal inhalers, oral steroids, or leukotriene inhibitors.

For these patients, a pharmacist can assist in a more traditional sense by alleviating any burdens associated with adjudicating and dispensing their prescription medications. This role can also be significant because many of these medications, especially the inhaler products, can be quite costly and may often require prior authorization. Additionally, first-time inhaler users will greatly benefit from counseling from a pharmacist regarding how to properly use an inhaler to get the most from the therapy.

The pharmacist’s role in seasonal allergy management does not stop here. Although most patients will be able to use simple OTC remedies or commonly prescribed pharmaceutical products to manage their allergies, an appreciable sector of allergy patients need more specialized medications to properly treat this disease state.

These patients will likely see a specialist and will require less commonly used treatment options, such as immunotherapy injections, sublingual immunotherapy products, or biological medications. Many of these rarer and newer-to-market therapies often fall under the umbrella of specialty medications.

A specialty pharmacist’s role here is equally as important as in the other more common treatment scenarios. Patients who require specialty medications often need more support than other patients because of the complex nature of the medications as well as the specialty pharmacy process.

Although most allergy specialists are likely familiar with the specialty prescription dispensing process, some may not be. Therefore, it may take significant pharmacist intervention to ensure the prescription arrives at an appropriate specialty pharmacy where it can be successfully billed and dispensed. This can take several days or attempts, depending on the situation and the patient’s insurance.

Specialty pharmacists play a very important role in ensuring allergy patients can afford their medications which are typically quite expensive but might be less expensive after an insurance intervention or manufacturer coupon or rebate. Additionally, these patients will need thorough education and counseling regarding their new medications, which often have unique administration and/or storage requirements as well as more significant adverse effects.

In summation, there is clearly a wide range in the type of support patients will need in managing their seasonal allergies. Luckily for these patients, pharmacists are skilled and able to assist from the start of the process with symptom recognition and diagnosis to making OTC recommendations to helping those with severe symptoms manage a complex situation, as well as in the many situations in between.

Similarly to many other disease states or conditions, the role of pharmacists is vital and ever present in helping the many Americans who fight seasonal allergies navigate and successfully treat their symptoms.

About the Author

Molly Gombos,PharmD, MPBA, earned her Doctor of Pharmacy degree from the University of Pittsburgh in 2014 and her Master of Pharmacy Business Administration (MPBA) in 2021 from the University of Pittsburgh, a 12-month, executive-style graduate education program designed for working professionals striving to be tomorrow’s leaders in the business of medicines. Molly has spent the last 7 years working in community pharmacy, initially as a pharmacist and pharmacy manager and most recently working in pharmacy operations. Her current role is working in the patient safety and clinical space with focus on clinical decision support.