ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma a

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. © 2018 John Wiley & Sons Lt

Pilot study of mobile phone technology in allergic rhinitis in European countries: the MASK-rhinitis study

Background: The use of Apps running on smartphones and tablets profoundly affects medicine. The MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) App (Allergy Diary) assesses allergic rhinitis symptoms, disease control and impact on patients’ lives. It is freely available in 20 countries (iOS and Android platforms). Aims: To assess in a pilot study whether (i) Allergy Diary users were able to properly provide baseline characteristics (ii) simple phenotypic characteristics based upon data captured by the Allergy Diary could be identified and (iii) information gathered by this study could suggest novel research questions. Methods: The Allergy Diary users were classified into six groups according to the baseline data that they entered into the App: (i) asymptomatic; (ii) nasal symptoms excluding rhinorrhea; (iii) rhinorrhea; (iv) rhinorrhea plus 1–2 nasal/ocular symptoms; (v) rhinorrhea plus ≥3 nasal/ocular symptoms; and (vi) rhinorrhea plus all nasal/ocular symptoms. Results: By 1 June 2016, 3260 users had registered with the Allergy Diary and 2710 had completed the baseline questionnaire. Troublesome symptoms were found mainly in the users with the most symptoms. Around 50% of users with troublesome rhinitis and/or ocular symptoms suffered work impairment. Sleep was impaired by troublesome symptoms and nasal obstruction. Conclusions: This is the first App (iOS and Android) to have tested for allergic rhinitis and conjunctivitis. A simple questionnaire administered by cell phones enables the identification of phenotypic differences between a priori defined rhinitis groups. The results suggest novel concepts and research questions in allergic rhinitis that may not be identified using classical methods. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Lt

Mobile technology offers novel insights into the control and treatment of allergic rhinitis: The MASK study

Background: Mobile health can be used to generate innovative insights into optimizing treatment to improve allergic rhinitis (AR) control.Objectives: A cross-sectional real-world observational study was undertaken in 22 countries to complement a pilot study and provide novel information on medication use, disease control, and work productivity in the everyday life of patients with AR.Methods: A mobile phone app (Allergy Diary, which is freely available on Google Play and Apple stores) was used to collect the data of daily visual analogue scale (VAS) scores for (1) overall allergic symptoms; (2) nasal, ocular, and asthma symptoms; (3) work; and (4) medication use by using a treatment scroll list including all allergy medications (prescribed and over-the-counter) customized for 22 countries. The 4 most common intranasal medications containing intranasal corticosteroids and 8 oral H-1-antihistamines were studied.Results: Nine thousand one hundred twenty-two users filled in 112,054 days of VASs in 2016 and 2017. Assessment of days was informative. Control of days with rhinitis differed between no (best control), single (good control for intranasal corticosteroid-treated days), or multiple (worst control) treatments. Users with the worst control increased the range of treatments being used. The same trend was found for asthma, eye symptoms, and work productivity. Differences between oral H-1-antihistamines were found.Conclusions: This study confirms the usefulness of the Allergy Diary in accessing and assessing behavior in patients with AR. This observational study using a very simple assessment tool (VAS) on a mobile phone had the potential to answer questions previously thought infeasible.Prevention, Population and Disease management (PrePoD)Public Health and primary car

Pooling birth cohorts in allergy and asthma: European union-funded initiatives-a MeDALL, CHICOS, ENRIECO, and GALEN joint paper: CHICOS study group ENRIECO study group GA2LEN study group

Long-term birth cohort studies are essential to understanding the life course and childhood predictors of allergy and the complex interplay between genes and the environment (including lifestyle and socioeconomic determinants). Over 100 cohorts focusing on asthma and allergy have been initiated in the world over the past 30 years. Since 2004, several research initiatives funded under the EU Framework Program for Research and Technological Development FP6-FP7 have attempted to identify, compare, and evaluate pooling data from existing European birth cohorts (GA2LEN: Global Allergy and European Network, FP6; ENRIECO: Environmental Health Risks in European Birth Cohorts, FP7; CHICOS: Developing a Child Cohort Research Strategy for Europe, FP7; MeDALL: Mechanisms of the Development of ALLergy, FP7). However, there is a general lack of knowledge about these initiatives and their potentials. The aim of this paper is to review current and past EU-funded projects in order to make a summary of their goals and achievements and to suggest future research needs of these European birth cohort networks. \ua9 2012 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

Management of anaphylaxis due to COVID-19 vaccines in the elderly

Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID-19 vaccines due to high risk of death. In very rare instances, the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA-EAACI-EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID-19 vaccines. Anaphylaxis to COVID-19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients. © 2021 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd

Management of anaphylaxis due to COVID-19 vaccines in the elderly

none149siOlder adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID-19 vaccines due to high risk of death. In very rare instances, the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA-EAACI-EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID-19 vaccines. Anaphylaxis to COVID-19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients.noneBousquet J.; Agache I.; Blain H.; Jutel M.; Ventura M.T.; Worm M.; Del Giacco S.; Benetos A.; Bilo B.M.; Czarlewski W.; Abdul Latiff A.H.; Al-Ahmad M.; Angier E.; Annesi-Maesano I.; Atanaskovic-Markovic M.; Bachert C.; Barbaud A.; Bedbrook A.; Bennoor K.S.; Berghea E.C.; Bindslev-Jensen C.; Bonini S.; Bosnic-Anticevich S.; Brockow K.; Brussino L.; Camargos P.; Canonica G.W.; Cardona V.; Carreiro-Martins P.; Carriazo A.; Casale T.; Caubet J.-C.; Cecchi L.; Cherubini A.; Christoff G.; Chu D.K.; Cruz A.A.; Dokic D.; El-Gamal Y.; Ebisawa M.; Eberlein B.; Farrell J.; Fernandez-Rivas M.; Fokkens W.J.; Fonseca J.A.; Gao Y.; Gavazzi G.; Gawlik R.; Gelincik A.; Gemicioglu B.; Gotua M.; Guerin O.; Haahtela T.; Hoffmann-Sommergruber K.; Hoffmann H.J.; Hofmann M.; Hrubisko M.; Illario M.; Irani C.; Ispayeva Z.; Ivancevich J.C.; Julge K.; Kaidashev I.; Khaitov M.; Knol E.; Kraxner H.; Kuna P.; Kvedariene V.; Lauerma A.; Le L.T.T.; Le Moing V.; Levin M.; Louis R.; Lourenco O.; Mahler V.; Martin F.C.; Matucci A.; Milenkovic B.; Miot S.; Montella E.; Morais-Almeida M.; Mortz C.G.; Mullol J.; Namazova-Baranova L.; Neffen H.; Nekam K.; Niedoszytko M.; Odemyr M.; O'Hehir R.E.; Okamoto Y.; Ollert M.; Palomares O.; Papadopoulos N.G.; Panzner P.; Passalacqua G.; Patella V.; Petrovic M.; Pfaar O.; Pham-Thi N.; Plavec D.; Popov T.A.; Recto M.T.; Regateiro F.S.; Reynes J.; Roller-Winsberger R.E.; Rolland Y.; Romano A.; Rondon C.; Rottem M.; Rouadi P.W.; Salles N.; Samolinski B.; Santos A.F.; S Sarquis F.; Sastre J.; M. G. A. Schols J.; Scichilone N.; Sediva A.; Shamji M.H.; Sheikh A.; Skypala I.; Smolinska S.; Sokolowska M.; Sousa-Pinto B.; Sova M.; Stelmach R.; Sturm G.; Suppli Ulrik C.; Todo-Bom A.M.; Toppila-Salmi S.; Tsiligianni I.; Torres M.; Untersmayr E.; Urrutia Pereira M.; Valiulis A.; Vitte J.; Vultaggio A.; Wallace D.; Walusiak-Skorupa J.; Wang D.-Y.; Waserman S.; Yorgancioglu A.; Yusuf O.M.; Zernotti M.; Zidarn M.; Chivato T.; Akdis C.A.; Zuberbier T.; Klimek L.Bousquet, J.; Agache, I.; Blain, H.; Jutel, M.; Ventura, M. T.; Worm, M.; Del Giacco, S.; Benetos, A.; Bilo, B. M.; Czarlewski, W.; Abdul Latiff, A. H.; Al-Ahmad, M.; Angier, E.; Annesi-Maesano, I.; Atanaskovic-Markovic, M.; Bachert, C.; Barbaud, A.; Bedbrook, A.; Bennoor, K. S.; Berghea, E. C.; Bindslev-Jensen, C.; Bonini, S.; Bosnic-Anticevich, S.; Brockow, K.; Brussino, L.; Camargos, P.; Canonica, G. W.; Cardona, V.; Carreiro-Martins, P.; Carriazo, A.; Casale, T.; Caubet, J. -C.; Cecchi, L.; Cherubini, A.; Christoff, G.; Chu, D. K.; Cruz, A. A.; Dokic, D.; El-Gamal, Y.; Ebisawa, M.; Eberlein, B.; Farrell, J.; Fernandez-Rivas, M.; Fokkens, W. J.; Fonseca, J. A.; Gao, Y.; Gavazzi, G.; Gawlik, R.; Gelincik, A.; Gemicioglu, B.; Gotua, M.; Guerin, O.; Haahtela, T.; Hoffmann-Sommergruber, K.; Hoffmann, H. J.; Hofmann, M.; Hrubisko, M.; Illario, M.; Irani, C.; Ispayeva, Z.; Ivancevich, J. C.; Julge, K.; Kaidashev, I.; Khaitov, M.; Knol, E.; Kraxner, H.; Kuna, P.; Kvedariene, V.; Lauerma, A.; L. T. T., Le; Le Moing, V.; Levin, M.; Louis, R.; Lourenco, O.; Mahler, V.; Martin, F. C.; Matucci, A.; Milenkovic, B.; Miot, S.; Montella, E.; Morais-Almeida, M.; Mortz, C. G.; Mullol, J.; Namazova-Baranova, L.; Neffen, H.; Nekam, K.; Niedoszytko, M.; Odemyr, M.; O'Hehir, R. E.; Okamoto, Y.; Ollert, M.; Palomares, O.; Papadopoulos, N. G.; Panzner, P.; Passalacqua, G.; Patella, V.; Petrovic, M.; Pfaar, O.; Pham-Thi, N.; Plavec, D.; Popov, T. A.; Recto, M. T.; Regateiro, F. S.; Reynes, J.; Roller-Winsberger, R. E.; Rolland, Y.; Romano, A.; Rondon, C.; Rottem, M.; Rouadi, P. W.; Salles, N.; Samolinski, B.; Santos, A. F.; S Sarquis, F.; Sastre, J.; M. G. A. Schols J., ; Scichilone, N.; Sediva, A.; Shamji, M. H.; Sheikh, A.; Skypala, I.; Smolinska, S.; Sokolowska, M.; Sousa-Pinto, B.; Sova, M.; Stelmach, R.; Sturm, G.; Suppli Ulrik, C.; Todo-Bom, A. M.; Toppila-Salmi, S.; Tsiligianni, I.; Torres, M.; Untersmayr, E.; Urrutia Pereira, M.; Valiulis, A.; Vitte, J.; Vultaggio, A.; Wallace, D.; Walusiak-Skorupa, J.; Wang, D. -Y.; Waserman, S.; Yorgancioglu, A.; Yusuf, O. M.; Zernotti, M.; Zidarn, M.; Chivato, T.; Akdis, C. A.; Zuberbier, T.; Klimek, L