Effectiveness of Hay Fever Treatments: Cetirizine and Acupuncture

This report investigates the effectiveness of cetirizine hydrochloride compared to non-pharmacological acupuncture in reducing or preventing hay fever allergies in children within the UK. The introduction provides background on hay fever, its symptoms, causes, and the importance of prompt treatment. The study employs a literature review methodology, defining the PICO framework (Population, Intervention, Comparison, Outcome) to structure the research question and search strategy. The report outlines the chosen library databases, search keywords (including Boolean operators), search results at each stage, and the use of truncation and filters. Inclusion and exclusion criteria, strengths, and weaknesses of the search strategy are discussed. The report also presents a critical appraisal of the selected articles and offers conclusions and recommendations based on the findings. The background section describes cetirizine hydrochloride and acupuncture for hay fever, along with their respective mechanisms of action and potential side effects. The research aims to compare the efficacy of these two treatments for the welfare of children.

Research Methods and Critical
Appraisal

Table of Contents
TOPIC..............................................................................................................................................1
INTRODUCTION...........................................................................................................................1
BACKGROUND.............................................................................................................................1
RESEARCH METHODOLOGY.....................................................................................................4
CRITICAL APPRAISAL................................................................................................................7
DISCUSSION AND RECOMMENDATION.................................................................................8
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

TOPIC
“Is the Cetirizine Hydrochloride more effective than Non-pharmaceutical (Acupuncture)
treatment to reduce (or prevent) hay fever allergy in children in the UK?”
INTRODUCTION
Hay fever refers to a condition caused by an allergy that develops several symptoms like watery,
itchy eyes, sneezing and other similar signs. It includes common condition for allergic rhinitis
take places seasonally or year round. However, it has been analysed that hay fever take place in
response to an allergic reaction among children which should be treated immediately. It consist
the medical condition that can evaluated with the hep to examining several symptoms such as
runny nose, itchy eyes, congestion, sneezing and sinus pressure (Powell-Dunford and et. al.,
2018). It includes the cause of seasonal factors like tree pollen, grass pollen, dust mites,
cockroaches and spores. Basically, it is observed that hay fever is caused due to allergic response
due to outdoor or indoor allergens like pollen, dust times or tiny flecks of silk & saliva shed by
dogs, cats or other animals with fur or features. It is necessary for parents to immediately consult
with doctor for wellbeing of their child because delayed care may leads to complicated
conditions accordingly.
In context of this project, it is based on the use of cetirizine hydrochloride as compared to non-
pharmacological (acupuncture) treatment in order to reduce hay fever allergy among children. It
includes the study of effectiveness of given medication in terms of treating the health issue of
hay fever among children along with analysing potential of non-pharmacological intervention.
Meanwhile, the appropriate treatment for hay fever allergy among select two alternative
procedures will be studied for welfare of children in UK. The critical appraisal of selected
articles and use of desired research methods are given below.
BACKGROUND
The hay fever can be described as a condition which is known to be an allergic reaction that
occurs in children due to several factors. It can be considered as allergic rhinitis or nasal allergies
due to certain reasons like seasonal factors, perennial elements or occupation problems
(Redmond, Wada and Hauswirth, 2016). Meanwhile, it includes the condition of rhinitis which
refers to irritation or inflammation of the nose. It involves number of symptoms such as nasal
congestion, sneezing, watery, red or itchy eyes, coughing, itchy throat, postnasal drip, itchy nose,
1

sinus pressure & pain and itchy skin and runny nose. It has been analysed that cetirizine
hydrochloride is used to treat the problem of hay fever between kids in order to treat their
allergic symptom. Basically, it consist the utilisation of this medication in terms of reliving
allergy symptoms because it is a kind of antihistamine respectively. It involves the fact that
cetirizine hydrochloride is always used for treating the itching as well as swelling caused by
hives. However, it has been analysed that cetirizine is required to be used very carefully only on
prescription of registered physician along with taking several precautions to avoid its side
effects. It is necessary for to consider advice of doctor ad follow their instructions in accurate
manner to gain its benefits as well as ignoring related side effects respectively. Moreover, it is
observed that sleepiness is mostly evaluated in context of such medications the most important
thing is that parents should immediately consult again with doctor if their child do not have any
kind of improvement of their condition by taking cetirizine hydrochloride.
On the other hand, cetirizine hydrochloride has number of side effects on body such as
drowsiness, fatigue, tired feeling, dizziness, dry mouth, sore throat, cough, nausea, constipation
and headache. In case of children, stomach pain and vomiting is mostly observed as side effects
in them (BochenskaMarciniak, Kupczyk and Gorski, 2020). It has been analysed that effective
use of medication includes less or no side effects of human body. But the selected medicine of
cetirizine hydrochloride is beneficial to treat the problem of hay fever but it has side effects on
human body.
KEYWORDS
No Research
Keywords
PICO Filter with
full text
Publication
year 2010-
2020
Geography
of Europe
(keep the
year 2010-
2020)
By
Academic
journals
1. 1 P + 1 I +
1 C + 1 O
664,422 190,652 139,248 60,458 56,901
2. 2 P + 2 I +
2 C + 2 0
657,752
1,340
442 310 204 200
3. 3 P + 3 I + 2,986 731 529 184 136
2

3 C + 3 0 (only
use
Bolear
Logic
‘OR’)
4. 4 P + 4 I +
4 C + 4 0
20 5 (2008-2019
automatically
result)
2 9 (before full
text filter and
2013-2019
automatically
filter result)
6
5. 1 + 2 + 1
+ 1
105 27 14 5 (2011-
2019)
5
6. 1 + 2 + 2
+ 1
1,405 273 212 91 77
7. 1 + 2 + 3
+ 1
1,676 733 529 179 131
8. 1 + 4 + 1
+ 1
40 14 5 5 5
9. 1 + 4 + 2
+ 1
1,405 273 212 91 77
10. 1 + 4 + 3
+ 1
1,676 733 529 179 131
11. 1 + 1 +1 +
2
4,902 841 574 294 260
12. 1 + 1 + 1
+ 3
18 23 14 10 10
13. 1 + 1 + 1
+ 4
24 5 2 11 (before
filter with
full text and
other)
1
14. 2 + 1+ 1 + 546 137 81 57 40
3

1
15 2 + 1 +1 +
2
2,824 841 574 294 260
The non-pharmacological intervention of acupuncture can be considered as an effective
intervention in order to treat the problem of hay fever among children. It is beneficial because of
not having any kind of side effects due to which is suitable for them. Basically, the non-
pharmacological intervention is known as clinical process of treatment in which any kind of
drugs will not use and it is fully based on physical exercise and pressuring important point in
human body to treat specific health problem (Katoh and et. al., 2019). However, the acupuncture
can be considered as safe and effective clinical practices for reliving the seasonal allergenic
rhinitis which is generally called as hay fever. It includes a process by utilising special needles
which are required to be inserted into specific points on body of a child for treating the problem
of hay allergic. Meanwhile, acupuncture is known to be an effective clinical procedure for
children to treat the health problem of hay fever because it can heal the issue in effective manner.
It is observed that children can easily ready for this process and physician can gain desired
cooperation from patient who will provide support to improve their condition by solving the
allergic symptoms.
RESEARCH METHODOLOGY
Define what a literature review
Literature review can be defined as a process to review the relevant information by gathering it
from different research articles. It includes studying views, opinions and perspectives of different
authors who have already carried out investigation on same topic (Reszke and Szepietowski,
2019). However, it includes the utilisation of scholarly researched papers in order to collect
relevant data for conducting study in more effective as well as efficient manner.
Define and discuss the PICO framework and how you used it
PICO framework can be described as an effective model that can be used for carry out research
on specific question by considering elements of given model. It includes number of components
such as population or patient, intervention, comparison and outcomes of specific article.
Basically, this method is generally used in order to determine the factors of clinical evidence for
systematic reviews in evidence based medicine. However, this framework is used because it is
4

much favourable in terms of establishing search strategies with the help of identifying core
concept of research topic. In context of this study, the PICO model is used with the help of
determining target population and intervention with its comparative alternative along with
desired outcomes of intervention.
What library database was chosen and why was it chosen
The library data base can be considered as electronic data base which are required to be search
through internet to gather relevant information which helps to analyse different aspects related to
specific problem and its intervention (ÖZDEMİR and ElMAS, 2017). It is helpful to understand
about effectiveness of intervention and its comparative alternative option to study which is more
suitable in terms of target population. Meanwhile, this investigation is focus on 15 to 20 journals,
books and articles in order to gain relevant data about medication to relieve allergic hay fever.
Set out exactly the main search keywords with Boolean operators (the main search phrase)
The search key words used to investigate the research problem are hay fever, rhinitis, and
cetirizine hydrochloride, use and side effects of cetirizine hydrochloride, non-pharmacological
intervention, and acupuncture. It includes the utilisation of antihistamine, allergy, postnasal drip,
nasal congestion, sinus pressure and many more.
Describe the search
In context of this investigation, it has been analysed that different types of secondary sources in
terms of gathering desired information. It includes the information that can be used for studying
about effectiveness of cetirizine hydrochloride and acupuncture in respect of solving the problem
of allergic rhinitis or hay fever among children to identify which is better option to be used
respectively (Yameen and et. al., 2018).
Set out the number of search results at each stage of the search and the final number of
titles and abstracts that were read from which you selected the six studies (articles) (you
should narrow down to between 50-120 and then read titles and abstracts to identify 6
articles (studies) relevant to your literature review question)
There are number of articles which were searched and analysed for screening them in order to
select specific some of research articles to gain accurate information. It is helpful to gather more
effective as well as efficient data which facilitate to gain appropriate findings for selected
research topic. In context of this study, 3 articles were reviewed in order to conduct research in
proper manner.
5

What Boolean operators were used and explain how they help with searching for studies
(articles)
In respect of carry out this investigation, the researcher prefer to utilise the words like AND,
NOT and OR which are known to be main Boolean operators that is helpful further to narrow
down their data it will also provide help in terms of gaining valuable outputs respectively
(Nankervis and et. al., 2016). These Boolean operators can be considered as more appropriate in
terms of formulating the sentences and merge two statements in appropriate way.
Explain what truncation and filters/limiters are and explain how they help with searching
for studies
The truncation refers to more effective as well as efficient searching process which can be
utilised databases under that final word of specific statement should be replaced with the help of
respective symbols. It includes the utilisation of specific and appropriate symbols which helps to
formulate the statement in proper manner. Meanwhile, it has been analysed that the symbol of
question is used by researcher as a truncation. It is observed that the symbol of question is much
effective in respect of searching entire relevant data related to selected research topic.
Discuss the inclusion/exclusion criteria (did you limit the search to any number of years?
What about language? Other?)
The inclusion criterion of for this investigation is that, research article were considered 2015 to
2020 which provide support to gain more accurate information. The exclusion criterion involves
avoiding the previous research articles to avoid utilisation of old as well as inaccurate
information that may impact negatively on results of the study.
What are the strengths and weaknesses of your search strategy
In context of given investigation, the effective strength is search strategy is to gather accurate
information related to effectiveness of cetirizine hydrochloride and acupuncture in order to heal
with hay fever in children (Gu, 2018). It will provide support to boost up accuracy if data which
impact positively to achieve respective findings in effective manner. The weakness of selected
search strategy is that the process of collecting appropriate information is very time consuming.
Discuss briefly the key ethical issues that a literature reviewer would be looking for in
order for a study (article) to be used in a literature review (For example, research that
forces people to take part would be unethical and would not be used in a literature review)
6

The literature review includes collecting information from different website to review authors’
viewpoint related to effectiveness of cetirizine hydrochloride and acupuncture to heal hay fever
among children. It is necessary for investigator to fulfil ethical principles and follow then while
carrying out literature review. However, it is necessary to gather relevant data from authenticate
websites which impact on reliability and validity if the study and its findings.
CRITICAL APPRAISAL
Discuss what critical appraisal is and how you are going to appraise the literature? E.g.
using an official appraisal table, exploration of limitations, discussing validity, reliability,
generalizability
Critical appraisal can be defined as a systematic procedure that is utilised for determining
strengths and weaknesses of particular research articles. It includes the criterion of distinguishing
evidence from opinion, assumptions, misreporting and belief (Özdemir and Elmas, 2017).
However, the critical appraisal consists to carry out effective assessment of validity of the study,
its usefulness as well as applicability of the respective findings. Moreover, it involves assessing
outcomes of specific scientific research in careful and systematic way.
Description of three articles chosen
Article 1: Efficacy and Safety of Sanfu Herbal Patch at Acupoints for Persistent Allergic
Rhinitis: Study Protocol for a Randomized Controlled Trial.
Considering the given article, it has been analysed that sanfu herbal patch (SHP) is used in order
to treat the allergic rhinitis among children. It includes the criterion that utilisation of SHP at
acupoints is helpful for healing the problem of allergic hay fever of patients. However, it
includes use of randomised controlled trial and descriptive statistics to understand effectiveness
of using SHP. It involves the considering 5 trials sessions along with one year follow up and the
same procedure will repeated in second as well as third years (Xiankun and et. al., 2019).
Meanwhile, the eligible respondents were placed in ration of 2:2:1 into one of 3 groups like SHP
group, placebo group and waiting list groups respectively. It has been founded that use of non-
pharmacological i.e. using SHP with acupuncture treatment is much effective for children in
terms of healing the health issues of hay fever or allergic rhinitis along with improving quality of
lives. It has limitation because of not explaining specific benefits of using SHP but findings are
valid of having benefits to use the same at acupoints to gain better outcomes.
Article 2: Helping children thrive during hay fever season
7

As mentioned in selected article, it has been evaluated that hay fever is required to be treated
immediately because it is not only nuisance for kids but it has potential to affect social develop
as well as educational attainment. It includes the two problems such as seasonal allergic rhinitis
(hay fever) and perennial allergic rhinitis which are observed among children. Meanwhile, it is
necessary to focus on environmental control to avoid exposure of causing factors like cats, dogs,
horses etc. which may develop allergic rhinitis between kids (Jane and Steve, 2015). It has been
analysed that pharmacological therapy can be used like medications for easing symptoms and
blocking allergic response or by decreasing inflammation. However, it has been founded that
immunotherapy and pollen avoidance strategy are effective to prevent the allergic rhinitis. This
investigation has limitation of using specific medications to relive allergic symptoms but it is
valid to apply findings to prevent occurrence of hay fever among children.
Article 3: Children and adolescents' health-related quality of life in relation to eczema, asthma
and hay fever: results from a population-based cross-sectional study.
With the considering selected article, it has been evaluated that quality of life is required to be
focussed related to health condition for improving the same. It includes the use of population
based sample (n= 6518) children along with adolescents aged between 11 to 17 years old.
However, it has been founded that atopic conditions are responsible for affecting the health-
related quality of life (HRQoL). It has limitation to explain about effective treatment to heal with
hay fever but it is valid to focus on quality of life by improving health condition of children
(Matterne and et. al., 2017). It is necessary to consider atopic conditions to prevent occurrence of
hay fever between kids by taking effective precautions.
DISCUSSION AND RECOMMENDATION
According to the above information, it has been analysed that cetirizine hydrochloride is much
effective in terms of treating the problem of hay fever among children but it has some of side
effects as well. It is required to be avoid by care professionals while treating allergic rhinitis
among kids if other more effective treatment option is available, however, it has been
recommended that non-pharmacological intervention of using acupuncture is efficient in respect
of treating the hay fever between children. It does not have any side effects and suitable to be
applied for wellbeing of children. It is suggested for parents to protect their kids from harmful
factors cause allergic rhinitis like cats, dogs, pollen exposure in terms of preventing the hay fever
in children.
8

CONCLUSION
From the above assignment, it has been concluded that cetirizine hydrochloride is known as an
antihistamine which is mostly used to relieve the allergic reactions including hay fever among
children. It includes the effectiveness of cetirizine hydrochloride but it has some of side effects
due to which it is suitable for kids. However, the use of acupuncture intervention is much
effective to heal the problem of allergic rhinitis among children with having no side effects on
patients.
9

REFERENCES
Books and journals
Powell-Dunford, N. and et. al., 2018. The Aeromedical Management of Allergic
Rhinitis. Aerospace medicine and human performance, 89(5), pp.453-463.
Redmond, M.T., Wada, K.J. and Hauswirth, D.W., 2016. Pediatric Allergic Rhinitis: the
Stepwise Treatment Approach. Current Treatment Options in Allergy, 3(3), pp.253-267.
BochenskaMarciniak, M., Kupczyk, M. and Gorski, P., 2020. Outcome measures. Mediators of
inflammation, 4, p.17.
Katoh, N. and et. al., 2019. Clinical practice guidelines for the management of atopic dermatitis
2018. The Journal of dermatology, 46(12), pp.1053-1101.
Reszke, R. and Szepietowski, J.C., 2019. Itch: An Integrative Approach. Advances in Integrative
Dermatology, p.187.
ÖZDEMİR, Ö. and ElMAS, B., 2017. Allerjik Rinit Tanı ve Tedavisindeki Yenilikler. Asthma
Allergy Immunology/Astim Allerji Immunoloji, 15(1).
Yameen, M. and et. al., 2018. Conventional and Alternative Treatment Options for Allergic
Rhinitis. Current Respiratory Medicine Reviews, 14(1), pp.29-34.
Nankervis, H. and et. al., 2016. Scoping systematic review of treatments for eczema. Programme
Grants for Applied Research, 4(7), pp.1-480.
Gu, X.M., 2018. Evidence-based Chinese medicine approach for atopic eczema: current state of
evidence and future priority.
Özdemir, Ö. and Elmas, B., 2017. New Developments in the Diagnosis and Therapy of Allergic
Rhinitis. Asthma Allergy Immunology, 15(1), pp.1-16.
Online
Xiankun C. and et. al., 2019. Efficacy and Safety of Sanfu Herbal Patch at Acupoints for
Persistent Allergic Rhinitis: Study Protocol for a Randomized Controlled Trial. [Online].
Available through:<https://web-b-ebscohost-com.ezproxy.uwl.ac.uk/ehost/detail/detail?
vid=0&sid=e928fa03-313f-4092-8b08-258fb60165c3%40pdc-v-
sessmgr04&bdata=JkF1dGhUeXBlPWlwLHNoaWImc2l0ZT1laG9zdC1saXZl#AN=109030778
&db=ccm>
Jane S. and Steve H., 2015. Helping children thrive during hay fever season. [Online]. Available
through:<https://web-b-ebscohost-com.ezproxy.uwl.ac.uk/ehost/detail/detail?
vid=0&sid=a8d93c82-ba18-460f-b57d-f31cc69a1f33%40pdc-v-
sessmgr06&bdata=JkF1dGhUeXBlPWlwLHNoaWImc2l0ZT1laG9zdC1saXZl#AN=109808996
&db=ccm>
Matterne U. and et. al., 2017. Children and adolescents' health-related quality of life in relation to
eczema, asthma and hay fever: results from a population-based cross-sectional study. [Online].
Available through:<https://web-b-ebscohost-com.ezproxy.uwl.ac.uk/ehost/detail/detail?
vid=0&sid=75e34157-423b-4506-bdd5-9f0f1629b0d6%40pdc-v-
sessmgr02&bdata=JkF1dGhUeXBlPWlwLHNoaWImc2l0ZT1laG9zdC1saXZl#AN=104583572
&db=ccm>
10