Normocaloric diet improves asthma-related quality of life in obese pubertal adolescents

Background: Restrictive, very low-energy diets focused on rapid weight loss have proven to be effective in improving asthma outcome in obese patients, but their use in children and pubescents is controversial due its potential consequences in growth. More conservative, normocaloric schemes are suggested as a more suitable dietary approach for these patients. Methods: A randomized clinical trial was run of 51 pubertal adolescents with asthma and obesity, who were allocated to either an interventional 28-week program of normocaloric diet based on normal requirements for height and meal planning (n = 26) or a non-interventional (free diet) control group (n = 25). Asthma-related quality of life (AR-QOL, assessed by the Standardized Pediatric Asthma Quality of Life Questionnaire, PAQLQ[S]) and clinical indicators of asthma control were measured before and after the intervention period. Results: Diet intervention was associated with a significant improvement in AR-QOL in relation to baseline (? PAQLQ[S] scores) compared with controls, both in overall score (p < 0.001) and its subdomains (activity limitation, p < 0.001; symptoms, p < 0.002; emotional function, p < 0.001). The group with normocaloric diet observed a significant decrease in body mass index z-score, which correlated positively with the improvement in AR-QOL (Spearman's r = 0.51, p < 0.01), in addition to have significantly fewer events of acute attacks of asthma and nighttime awakenings, plus a non-significant reduction in the use of inhaled corticosteroids. No significant changes were observed in the pulmonary function tests. Conclusion: The normocaloric dietary intervention was associated with improvement of AR-QOL and some aspects of asthma control. Such structured dietary programs could probably have a role as a complementary non-pharmacological therapeutic strategy in obese pubertal adolescents with asthma. � 2014 S. Karger AG, Basel

Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries.Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App.Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach.Results: A total of 12143 users were registered. A total of 6949 users reported at least one VAS data recording. Among them, 1887 users reported >= 7 VAS data. About 1195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR >= 70% and PDC = 70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR <70%). Of those, the largest group was non-adherent to medications and the time interval was increased in 442 (36.68%) users.Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting.Public Health and primary carePrevention, Population and Disease management (PrePoD

Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.Public Health and primary carePrevention, Population and Disease management (PrePoD

Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries. Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App. Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach. Results: A total of 12 143 users were registered. A total of 6 949 users reported at least one VAS data recording. Among them, 1 887 users reported ≥7 VAS data. About 1 195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR ≥70% and PDC ≤1.25), 51 (4.23%) were partly adherent (MPR ≥70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR <70%). Of those, the largest group was non-adherent to medications and the time interval was increased in 442 (36.68%) users. Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting