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Browsing by Author "Fonseca, João"

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  • 2019 ARIA Care pathways for allergen immunotherapy
    Publication . Bousquet, Jean; Pfaar, Oliver; Togias, Alkis; Schünemann, Holger J; Ansotegui, Ignacio; Papadopoulos, Nikolaos G; Tsiligianni, Ioanna; Agache, Ioana; Anto, Josep M.; Bachert, Claus; Bedbrook, Anna; Bergmann, Karl-Christian; Bosnic-Anticevich, Sinthia; Bosse, Isabelle; Brozek, Jan; Calderon, Moises A; Canonica, Giorgio W; Caraballo, Luigi; Cardona, Victoria; Casale, Thomas; Cecchi, Lorenzo; Chu, Derek; Costa, Elísio; Cruz, Alvaro A; Czarlewski, Wienczyslawa; Durham, Stephen R; Du Toit, George; Dykewicz, Mark; Ebisawa, Motohiro; Fauquert, Jean Luc; Fernandez-Rivas, Montserrat; Fokkens, Wytske J; Fonseca, João; Fontaine, Jean-François; Gerth van Wijk, Roy; Haahtela, Tari; Halken, Susanne; Hellings, Peter; Ierodiakonou, Despo; Iinuma, Tomohisa; Ivancevich, Juan Carlos; Jacobsen, Lars; Jutel, Marek; Kaidashev, Igor; Khaitov, Musa; Kalayci, Omer; Kleine Tebbe, Jörg; Klimek, Ludger; Kowalski, Marek L; Kuna, Piotr; Kvedarienė, Violeta; La Grutta, Stefania; Larenas Linnemann, Désirée; Lau, Susanne; Laune, Daniel; Le Thi Tuyet, Lan; Lodrup Carlsen, Karin; Lourenço, Olga; Malling, Hans-Jørgen; Marien, Gert; Menditto, Enrica; Mercier, Gregoire; Mullol, Joaquim; Muraro, Antonella; O'Hehir, Robyn; Okamoto, Yoshitaka; Pajno, Giovanni B; Park, Hae-Sim; Panzner, Petr; Passalacqua, Giovanni; Pham-Thi, Nhan; Roberts, Graham; Pawankar, Ruby; Rolland, Christine; Rosario, Nelson; Ryan, Dermot; Samolinski, Boleslaw; Sanchez-Borges, Mario; Scadding, Glenis; Shamji, Mohamed H; Sheikh, Aziz; Sturm, Gunter J; Todo-Bom, Ana; Toppila-Salmi, Sanna; Valentin Rostan, Marylin; Valiulis, Arunas; Valovirta, Erkka; Ventura, Maria Teresa; Wahn, Ulrich; Walker, Samantha; Wallace, Dana; Waserman, Susan; Yorgancioglu, Arzu; Zuberbier, Torsten
    Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including healthcare professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow-up of patients.
    2019-11Journal article Open access Show more
  • ARIA pharmacy 2018: Allergic rhinitis care pathways for community pharmacy
    Publication . Bosnic-Anticevich, Sinthia; Costa, Elísio; Menditto, Enrica; Lourenço, Olga; Novellino, Ettore; Bialek, Slawomir; Briedis, Vitalis; Buonaiuto, Roland; Chrystyn, Henry; Cvetkovski, Biljana; Di Capua, Stefania; Park, Hae-Sim; Phillips, Jim; Plavec, Davor; Stellato, Cristiana; Somekh, David; Sisul, Juan; To, Teresa; Todo-Bom, Ana; Tomazic, Peter Valentin; Toppila-Salmi, Sanna; Valero, Antonio; Popov, Todor A; Potter, Paul C; Prokopakis, Emmanuel P; Roller-Wirnsberger, Regina E; Rottem, Menachem; Ryan, Dermot; Samolinski, Boleslaw; Sanchez-Borges, Mario; Schunemann, Holger J; Sheikh, Aziz; Ventura, Maria Teresa; Valovirta, Erkka; Valiulis, Arunas; Wagenmann, Martin; Kritikos, Vicky; Bousquet, Jean; Zuberbier, Torsten; Mair, Alpana; Orlando, Valentina; Paulino, Ema; Salimäki, Johanna; Söderlund, Rojin; Wallace, Dana; Waserman, Susan; Wickman, Magnus; Yiallouros, Panayiotis; Yorgancioglu, Arzu; Yusuf, Osman; Zar, Heather J; Zernotti, Mario E; Zhang, Luo; Zidarn, Mihaela; Wroczynski, Piotr; Williams, Dennis M; Tan, Rachel; Agache, Ioana; Ansotegui, Ignacio J; Cruz, Alvaro A; Sousa, Jaime Correia de; Chavannes, Niels H; Czarlewski, Wienczyslawa; De Carlo, Giuseppe; Demoly, Pascal; Devillier, Philippe; Anto, Josep M; Bedbrook, Anna; Bachert, Claus; Bewick, Mike; Bindslev-Jensen, Carsten; Brozek, Jan L; Canonica, Giorgio Walter; Cardona, Victoria; Carr, Warner; Casale, Thomas; El-Gamal, Yehia; Gaga, Mina; Dykewicz, Mark S; Fonseca, João; Fokkens, Wytske J; Kuna, Piotr; Kowalski, Marek; Klimek, Ludger; Kvedarienė, Violeta; Linnemann, Désirée Larenas; Laune, Daniel; Le Thi Tuyet, Lan; Guzman, Maria Antonieta; Haahtela, Tari; Hellings, Peter; Illario, Maddalena; Ivancevich, Juan Carlos; Just, Jocelyne; Kaidashev, Igor; Khaitov, Musa; Khaltaev, Nikolai; Keil, Thomas; Maier, Dieter; Mahboub, Bassam; Lodrup Carlsen, Karin C; Malva, João; Manning, Patrick J; Okamoto, Yoshitaka; Ohta, Ken; O'Hehir, Robyn; Onorato, Gabrielle L; Palkonen, Susanna; Panzner, Petr; Papadopoulos, Nikolaos G.; Almeida, Mário Morais; Mösges, Ralph; Mullol, Joaquim; Münter, Lars; Murray, Ruth; Naclerio, Robert; Namazova-Baranova, Leyla; Nekam, Kristof; Nyembue, Tshipukane Dieudonné; Okubo, Kimihiro; Pfaar, Oliver; Pawankar, Ruby
    Pharmacists are trusted health care professionals. Many patients use over-the-counter (OTC) medications and are seen by pharmacists who are the initial point of contact for allergic rhinitis management in most countries. The role of pharmacists in integrated care pathways (ICPs) for allergic diseases is important. This paper builds on existing studies and provides tools intended to help pharmacists provide optimal advice/interventions/strategies to patients with rhinitis. The Allergic Rhinitis and its Impact on Asthma (ARIA)-pharmacy ICP includes a diagnostic questionnaire specifically focusing attention on key symptoms and markers of the disease, a systematic Diagnosis Guide (including differential diagnoses), and a simple flowchart with proposed treatment for rhinitis and asthma multimorbidity. Key prompts for referral within the ICP are included. The use of technology is critical to enhance the management of allergic rhinitis. However, the ARIA-pharmacy ICP should be adapted to local healthcare environments/situations as regional (national) differences exist in pharmacy care.
    2019-07Journal article Restricted access Show more
  • Evaluation of allergic rhinitis and asthma control in a Portuguese community pharmacy setting
    Publication . Lourenço, Olga; Calado, Sofia; Sá-Sousa, Ana; Fonseca, João
    BACKGROUND: Allergic rhinitis and asthma (ARA) are frequent respiratory diseases that often coexist, causing a high social and economic impact. It is important to maintain ARA disease control to reduce the disease burden. OBJECTIVE: To assess control in patients with 1 or both pathologies through the application of validated questionnaires at community pharmacies. METHODS: A cross-sectional study was conducted in the pharmacies of the Portuguese county of Covilhã (located in the central region of Portugal with about 53,000 inhabitants). Subjects aged between 18 and 70 years who presented a prescription for an asthma and/or allergic rhinitis medication were invited to participate in the study by responding to a questionnaire that included the Control of Allergic Rhinitis and Asthma Test (CARAT). The CARAT is a validated tool to simultaneously assess the control of ARA with scores that range from 0 to 30 points, 0 meaning the worst and 30 meaning the best possible control of disease. RESULTS: Of the 224 participants, 58% were female and the median age was 48.5 years. The median CARAT score was 19 (mean = 17.8 ± 5136.4), and 87% of participants had a score < 25, indicating noncontrolled disease. Female participants, the elderly, and those with less school education responded with scores that demonstrated significantly less disease control. CONCLUSIONS: Using a simple self-assessment questionnaire, such as the CARAT, pharmacists can help identify patients with uncontrolled ARA disease, which is an important first step to change patients’ knowledge about their disease, with an ultimate goal of improving ARA outcomes.
    2014-05Journal article Open access Show more