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- Managing Allergic Rhinitis in the Pharmacy: An ARIA Guide for Implementation in PracticePublication . Lourenço, Olga; Bosnic-Anticevich, Sinthia; Costa, Elísio; Fonseca, Joao A; Menditto, Enrica; Cvetkovski, Biljana; Kritikos, Vicky; Tan, Rachel; Bedbrook, Anna; Scheire, Sophie; Bachert, Claus; Białek, Sławomir; Briedis, Vitalis; Boussery, Koen; Canonica, G Walter; Haahtela, Tari; Kuna, Piotr; Novellino, Ettore; Samolinski, Boleslaw; Schünemann, Holger J; Wallace, Dana; Bousquet, JeanThe paradigm of how we manage allergic rhinitis is shifting with a growing understanding that it is a complex process, requiring a coordinated effort from healthcare providers and patients. Pharmacists are key members of these integrated care pathways resolving medication-related problems, optimizing regimens, improving adherence and recommending therapies while establishing liaisons between patients and physicians. Community pharmacists are the most accessible healthcare professionals to the public and allergic rhinitis is one of the most common diseases managed by pharmacists. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines developed over the past 20 years have improved the care of allergic rhinitis patients through an evidence-based, integrated care approach. In this paper, we propose an integrated approach to allergic rhinitis management in community pharmacy following the 2019 ARIA in the pharmacy guidelines.
- Inhaler training and asthma knowledge are associated with a higher proportion of patients with correct inhaler technique in young but not in elderly asthmatic patientsPublication . Ferreira, Eduardo Freitas; Pascoal, Adriana dos Santos; Silva, Patrícia; Lourenço, Olga; Valente, Maria La Salete; Valente, Maria de Jesus; Loureiro, Marli; Gama, Jorge; Fonseca, Joao A; Taborda Barata, LuisObjective: Incorrect inhaler usage is frequent, particularly in elderly asthmatic patients. This study aimed at comparing inhaler technique errors and their determinants, as well inhaler technique self-perception versus real performance, between elderly and non-elderly asthmatics. Methods: Cross-sectional assessment of 92 elderly and 100 non-elderly asthmatics followed at specialty clinics. A standardized questionnaire was applied and inhaler technique demonstration was requested. Errors were assessed using checklists based on manufacturers’ instructions and inhaler technique was graded as correct, acceptable or incorrect. Chi-Square Test and Fischer’s Exact Test were used for comparative analysis of nominal variables. A p value equal to or less than 0.05 was considered statistically significant. Results: Inhaler technique was correct in a minority of elderly and young patients, without significant differences between study groups. Only 11.1% of the elderly who classified their inhaler as easy and 12.7% who stated their technique was correct had no errors. Previous regular inhaler training was associated with better actual performance in young but not in elderly patients. Conclusion: Our study showed that in spite of regular follow up at specialized outpatient clinics, inhaler devices are associated with a high frequency of errors in elderly and non-elderly asthmatics. In addition, most patients tend to overestimate their technique as correct. Finally, previous, frequent training was associated with a significantly higher percentage of patients showing correct or acceptable technique but only in non-elderly asthmatics, which suggests that elderly asthmatics may need specifically tailored inhaler education programs.
- Patient‐centered digital biomarkers for allergic respiratory diseases and asthma: The ARIA‐EAACI approach – ARIA‐EAACI Task Force ReportPublication . Bousquet, Jean; Shamji, Mohamed; Anto, Josep M.; Schünemann, Holger; Canonica, Giorgio Walter; Jutel, Marek; Del Giacco, Stafano; Zuberbier, Torsten; Pfaar, Oliver; Fonseca, Joao A; Pinto, Bernardo Sousa; Pétré, Benoit; Pham‐Thi, Nhân; Puggioni, Francesca; Quirce, Santiago; Roche, Nicolas; Rouadi, Philip; Sousa, Ana Sá; Sagara, Hironori; Sastre, Joaquin; Scichilone, Nicola; Sheikh, Aziz; Sova, Milan; Ulrik, Charlotte Suppli; Taborda Barata, Luis; Todo-Bom, Ana; Torres, María Jose; Tsiligianni, Ioanna; Usmani, Omar; Valovirta, Erkka; Vasankari, Tuula; Vieira, Rafael José; Wallace, Dana; Waserman, Susan; Zidarn, Mihaela; Yorgancıoglu, Arzu; Zhang, Luo; Chivato, Tomás; Ollert, Markus; Klimek, Ludger; Czarlewski, Wienczyslawa; Bedbrook, Anna; Amaral, Rita; Ansotegui Zubeldia, Ignacio Javier; Bosnic-Anticevich, Sinthia; Braido, Fulvio; Loureiro, Cláudia Chaves; Gemicioglu, Bilun; Haahtela, Tari; Kulus, Marek; Kuna, Piotr; Kupczyk, Maciej; Matricardi, Paolo Maria; Regateiro, Frederico S.; Samoliński, Bolesław; Sofiev, Mikhail; Toppila-Salmi, Sanna; Valiulis, Arunas; Ventura, Maria Teresa; Bárbara, Cristina; Bergmann, Karl-Christian; Bewick, Michael; Blain, Hubert; Bonini, Matteo; Boulet, Louis-Philippe; Bourret, Rodolphe; Brusselle, Guy; Brussino, Luisa; Buhl, Roland; Cardona, Victoria; Casale, Thomas; Cecchi, Lorenzo; Charpin, Denis; Cherrez Ojeda, Ivan; Chu, Derek K; Cing, Cemal; Costa, Elísio; Cruz, Álvaro A.; Devillier, Philippe; Dramburg, Stephanie; Fokkens, Wytske; Gotua, Maia; Heffler, Enrico; Ispayeva, Zhanat; Ivancevich, Juan Carlos; Joos, Guy; Kaidashev, Igor; Kraxner, Helga; Kvedarienė, Violeta; Larenas Linnemann, Désirée; Laune, Daniel; Lourenço, Olga; Louis, Renaud; Mäkelä, Mika J.; Makris, Michael; Maurer, Marcus; Melén, Erik; Micheli, Yann; Almeida, Mário Morais; Mullol, Joaquim; Niedoszytko, Marek; O'Hehir, Robyn; Okamoto, Yoshitaka; Olze, Heidi; Papadopoulos, Nikolaos G.; Papi, Alberto; Patella, VincenzoBiomarkers for the diagnosis, treatment and follow-up of patients with rhinitis and/ or asthma are urgently needed. Although some biologic biomarkers exist in specialist care for asthma, they cannot be largely used in primary care. There are no validated biomarkers in rhinitis or allergen immunotherapy (AIT) that can be used in clinical practice. The digital transformation of health and health care (including mHealth) places the patient at the center of the health system and is likely to optimize the practice of allergy. Allergic Rhinitis and its Impact on Asthma (ARIA) and EAACI (European Academy of Allergy and Clinical Immunology) developed a Task Force aimed at proposing patient-reported outcome measures (PROMs) as digital biomarkers that can be easily used for different purposes in rhinitis and asthma. It first defined control digital biomarkers that should make a bridge between clinical practice, randomized controlled trials, observational real-life studies and allergen challenges. Using the MASK-air app as a model, a daily electronic combined symptom-medication score for allergic diseases (CSMS) or for asthma (e-DASTHMA), combined with a monthly control questionnaire, was embedded in a strategy similar to the diabetes approach for disease control. To mimic real-life, it secondly proposed quality-of- life digital biomarkers including daily EQ-5D visual analogue scales and the bi-weekly RhinAsthma Patient Perspective (RAAP). The potential implications for the management of allergic respiratory diseases were proposed.
- Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessmentPublication . Cachim, Afonso; Pereira, Ana Margarida; Almeida, Rute; Amaral, Rita; Correia, Magna Alves; Marques, Pedro Vieira; Loureiro, Cláudia Chaves; Ribeiro, Carmelita; Cardia, Francisca; Gomes, Joana; Vidal, Carmen; Silva, Eurico; Rocha, Sara; Rocha, Diana; Marques, Maria Luís; Páscoa, Rosália; Morais, Daniela; Cruz, Ana Margarida; Santalha, Marta; Simões, José Augusto Rodrigues; Silva, Sofia da; Silva, Diana; Gerardo, Rita; Bom, Filipa Todo; Morete, Ana; Vieira, Inês; Vieira, Pedro; Monteiro, Rosário; Raimundo, Rosário; Monteiro, Luís; Neves, Ângela; Santos, Carlos; Penas, Ana Margarida; Regadas, Rita; Marques, José Varanda; Rosendo, Inês; Aguiar, Margarida Abreu; Fernandes, Sara; Cardoso, Carlos Seiça; Pimenta, F.; Meireles, Patrícia; Gonçalves, Mariana; Fonseca, Joao A; Jácome, CristinaBackground Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment. Methods This study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100). Results A total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p < 0.001). A negligible non-significant correlation was found between the app and subjective measurements (ρ 0.118–0.156, p > 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001). Conclusions Adherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.
- Digitally‐enabled, patient‐centred care in rhinitis and asthma multimorbidity: The ARIA‐MASK‐air® approachPublication . Bousquet, Jean; Anto, Josep M.; Sousa-Pinto, Bernardo; Czarlewski, Wienczyslawa; Bedbrook, Anna; Haahtela, Tari; Klimek, Ludger; Pfaar, Oliver; Kuna, Piotr; Kupczyk, Maciej; Regateiro, Frederico S.; Palamarchuk, Yuliia; Pépin, Jean‐Louis; Pétré, Benoit; Picard, Robert; Pitsios, Constantinos; Puggioni, Francesca; Quirce, Santiago; Raciborski, Filip; Reitsma, Sietze; Roche, Nicolas; Samolinski, Boleslaw; Rodriguez‐Gonzalez, Monica; Romantowski, Jan; Sousa, Ana Sá; Serpa, Faradiba S.; Savouré, Marine; Shamji, Mohamed H.; Sova, Milan; Sperl, Annette; Stellato, Cristiana; Todo‐Bom, Ana; Valiulis, Arunas; Tomazic, Peter Valentin; Vandenplas, Olivier; Van Eerd, Michiel; Vasankari, Tuula; Viart, Frédéric; Waserman, Susan; Fonseca, Joao A; Zuberbier, Torsten; Yorgancioglu, Arzu; Arnavielhe, Sylvie; Basagaña, Xavier; Bergmann, Karl C.; Bosnic‐Anticevich, Sinthia; Brussino, Luisa; Canonica, Giorgio Walter; Cardona, Victoria; Cecchi, Lorenzo; Loureiro, Cláudia Chaves; Costa, Elísio; Cruz, Alvaro A.; Gemicioglu, Bilun; Fokkens, Wytske; Ivancevich, Juan Carlos; Kraxner, Helga; Kvedariene, Violeta; Linnemann, Désirée E. Larenas; Laune, Daniel; Louis, Renaud; Makris, Michael; Maurer, Marcus; Melén, Erik; Micheli, Yann; Almeida, Mário Morais; Mullol, Joaquim; Niedoszytko, Marek; Okamoto, Yoshitaka; Papadopoulos, Nikolaos G.; Patella, Vincenzo; Pham‐Thi, Nhân; Rouadi, Philip W.; Sastre, Joaquin; Scichilone, Nicola; Sheikh, Aziz; Sofiev, Mikhail; Barata, Luís Taborda; Salmi, Sanna Toppila; Tsiligianni, Ioanna; Valovirta, Erkka; Ventura, Maria Teresa; Vieira, Rafael José; Zidarn, Mihaela; Amaral, Rita; Ansotegui, Ignacio J.; Bédard, Annabelle; Benveniste, Samuel; Bewick, Michael; Jensen, Carsten Bindslev; Blain, Hubert; Bonini, Matteo; Bourret, Rodolphe; Braido, Fulvio; Martins, Pedro Carreiro; Charpin, Denis; Cherrez‐Ojeda, Ivan; Chivato, Tomas; Chu, Derek K.; Cingi, Cemal; Del Giacco, Stefano; de Blay, Frédéric; Devillier, Philippe; De Vries, Govert; Doulaptsi, Maria; Doyen, Virginie; Dray, Gérard; Fontaine, Jean‐François; Gomez, R. Maximiliano; Hagemann, Jan; Heffler, Enrico; Hofmann, Maja; Jassem, Ewa; Jutel, Marek; Keil, Thomas; Kritikos, Vicky; Kull, Inger; Kulus, Marek; Lourenço, Olga; Mathieu‐Dupas, Eve; Menditto, Enrica; Mösges, Ralph; Murray, Ruth; Nadif, Rachel; Neffen, Hugo; Nicola, Stefania; O’Hehir, Robyn; Olze, HeidiMASK‐air®, a validated mHealth app (Medical Device regulationClass IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK‐air® is a Good Practice of DG Santé on digitally‐enabled, patient‐centred care. Itis also a candidate Good Practice ofOECD (Organisation for EconomicCo‐operation and Development). MASK‐air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK‐air® data show that most rhinitis patients (i) are not adherent and do notfollow guidelines, (ii) use as‐needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recom mended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom‐medication score (ARIA‐EAACI‐CSMS) has been validated for clinical practice and trials. The implications of the novel MASK‐air® results should lead to change management in rhinitis and asthma.
- ARIA 2019: Um Percurso Assistencial Integrado para a Rinite Alérgica em PortugalPublication . Fonseca, Joao A; Gomes, Tiago Taveira; Pereira, Ana Margarida; Ferreira, Manuel Branco; Martins, Pedro Carreiro; Correia, Magna Alves; Sousa, Jaime Correia de; Costa, Elísio; Lourenço, Olga; Almeida, Mário Morais; Morête, Ana; Regateiro, Frederico; Bom, Ana Todo; Bachert, Claus; Pfaar, Oliver; Wallace, Dana; Bedbrook, Anna; Czarlewski, Wienczyslawa; Bousquet, JeanA iniciativa Allergic Rhinitis and Its Impact on Asthma (ARIA) teve início há mais de 20 anos e tem elaborado e disseminado orientações baseadas em evidência, e desenvolvido projetos na área da rinite alérgica. Esta iniciativa está atualmente focada em proporcionar orientações centradas no doente que contribuam para um percurso integrado entre os vários níveis de cuidados e que tirem partido de soluções digitais, tendo sido recomendada a introdução na prática clínica de percursos assistenciais integrados. Neste artigo descrevemos a adaptação para Portugal do documento ARIA Integrated Care Pathways. Após breve revisão sobre a epidemiologia e o impacto da rinite alérgica em Portugal e das atividades realizadas em Portugal no âmbito da iniciativa ARIA, é descrito o conjunto alargado de conhecimento utilizado para o desenvolvimento das recomendações para o tratamento farmacológico da rinite alérgica, recomendações essas baseadas na metodologia GRADE, evidência do mundo real adquirida por tecnologia móvel (mHealth) e resultante de estudos de câmara de exposição alergénica. Em seguida, são resumidos os percursos assistenciais integrados para imunoterapia com alergénios produzidas em 2019. Considera-se a imunoterapia com alergénios um exemplo de medicina de precisão e em que a utilização de tecnologias mHealth permitirá melhorar a estratificação para seleção dos doentes e monitorização da resposta. Estas recomendações foram consideradas como ‘boas práticas’ dos cuidados integrados centrados no doente apoiados por sistemas digitais da DG Santé (Direção Geral de Saúde e de Segurança Alimentar da União Europeia) e representam a estratégia de gestão da mudança da fase 4 do ARIA.
- Concepts for the Development of Person-Centered, Digitally Enabled, Artificial Intelligence–Assisted ARIA Care Pathways (ARIA 2024)Publication . Bousquet, Jean; Schünemann, Holger; Sousa-Pinto, Bernardo; Zuberbier, Torsten; Togias, Alkis; Samoliński, Bolesław; Bedbrook, Anna; Czarlewski, Wienczyslawa; Hofmann-Apitius, Martin; Litynska, Justyna; Vieira, Rafael José; Giuliano, Antonio F.M.; Gotua, Maia; Gradauskiene, Brigita; Guzman, Maria Antonieta; Hossny, Elham; Hrubiško, Martin; Iinuma, Tomohisa; Irani, Carla; Ispayeva, Zhanat; Ivancevich, Juan Carlos; Anto, Josep M.; Jartti, Tuomas; Jesenak, Milos; Julge, Kaja; Jutel, Marek; Kaidashev, Igor; Bennoor, Kazi Saifuddin; Khaltaev, Nicolai; Kirenga, Bruce; Kraxner, Helga; Kull, Inger; Fonseca, Joao A; Kulus, Marek; Kuna, Piotr; Kupczyk, Maciej; Kurchenko, Andriy; La Grutta, Stefania; Lane, Stephen; Miculinic, Neven; Lee, Sang Min; Le Thi Tuyet, Lan; Lkhagvaa, Battur; Brozek, Jan; Louis, Renaud; Mahboub, Bassam; Mäkelä, Mika J.; Makris, Michael; Maurer, Marcus; Melén, Eric; Milenkovic, Branislava; Mohammad, Yousser; Moniuszko, Marcin; Montefort, Stephen; Bognanni, Antonio; Moreira, Andre; Moreno, Pablo; Mullol, Joaquim; Nadif, Rachel; Nakonechna, Alla; Navarro-Locsin, Cecilia Gretchen; Neffen, Hugo; Nekam, Kristof; Niedoszytko, Marek; Nunes, Elizabete; Brussino, Luisa; Nyembue Tshipukane, Dieudonne; O’Hehir, Robyn; Ollert, Markus; Ohta, Ken; Okamoto, Yoshitaka; Okubo, Kimihiro; Olze, Heidi; Padukudru, Mahesh Anand; Palomares, Oscar; Pali-Schöll, Isabella; Canonica, Giorgio Walter; Panzner, Petr; Palosuo, Kati; Park, Hae-Sim; Passalacqua, Giovanni; Patella, Vincenzo; Pawankar, Ruby; Pétré, Benoît; Pitsios, Constantinos; Plavec, Davor; Popov, Todor A.; Cherrez Ojeda, Ivan; Puggioni, Francesca; Quirce, Santiago; Raciborski, Filip; Ramonaité, Agné; Recto, Marysia; Repka- Ramirez, María Susana; Roberts, Graham; Robles-Velasco, Karla; Roche, Nicolas; Rodriguez-Gonzalez, Monica; Cruz, Alvaro; Romualdez, Joel A.; Rottem, Menachem; Rouadi, Philip; Salapatas, Marianella; Sastre, Joaquin; Serpa, Faradiba; Sayah, Zineb; Scichilone, Nicola; Senna, Gianenrico; Sisul, Juan; Vecillas, Leticia De Las; Solé, Dirceu; Soto-Martinez, Manuel E.; Sova, Milan; Sozinova, Olga; Stevanovic, Katarina; Suppli Ulrik, Charlotte; Szylling, Anna; Tan, Frances M.; Tantilipikorn, Pongsakorn; Bom, Ana Todo; Dykewicz, Mark; Tomic Spiric, Vesna; Tsaryk, Vladyslav; Tsiligianni, Ioanna; Urrutia-Pereira, Marilyn; Valentin Rostan, Marylin; Sofiev, Mikhail; Valovirta, Erkka; Van Eerd, Michiel; Van Ganse, Eric; Vasankari, Tuula; Gemicioglu, Bilun; Vichyanond, Pakit; Viegi, Giovanni; Wallace, Dana; Wang, De Yun; Waserman, Susan; Wong, Gary; Worm, Margitta; Yusuf, Osman; Zaitoun, Fares; Zidarn, Mihaela; Giovannini, Mattia; Haahtela, Tari; Jacobs, Marc; Jacomelli, Cristina; Klimek, Ludger; Kvedarienė, Violeta; Linnemann, Désirée Larenas; Louis, Gilles; Lourenço, Olga; Leemann, Lucas; Almeida, Mario Morais; Neves, Ana Luisa; Nadeau, Kari; Nowak, Artur; Palamarchuk, Yuliia; Palkonen, Susanna; Papadopoulos, Nikolaos G.; Parmelli, Elena; Pereira, Ana Margarida; Pfaar, Oliver; Regateiro, Frederico S.; Savouré, Marine; Barata, Luís Taborda; Toppila-Salmi, Sanna Katriina; Torres, María Jose; Valiulis, Arunas; Ventura, Maria Teresa; Williams, Siân; Yepes-Nuñez, Juan J.; Yorgancıoglu, Arzu; Zhang, Luo; Zuberbier, Jaron; Abdul Latiff, Amir; Abdullah, Baharudin; Agache, Ioana; Al-Ahmad, Mona; Al-Nesf, Maryam A Y; Al Shaikh, A.; Amaral, Rita; Ansotegui Zubeldia, Ignacio Javier; Asllani, Julijana; Balotro-Torres, Maria Cristina; Bergmann, Karl-Christian; Bernstein, Jonathan; Bindslev-Jensen, Carsten; Blaiss, Michael S.; Bonaglia, Cristina; Bonini, Matteo; Bossé, Isabelle; Braido, Fulvio; Caballero-Fonseca, Fernan; Camargos, Paulo; Martins, Pedro Carreiro; Casale, Thomas; Castillo-Vizuete, José-Antonio; Cecchi, Lorenzo; Teixeira, Maria Do Céu; Chang, Yoon-Seok; Loureiro, Cláudia Chaves; Christoff, George; Ciprandi, Giorgio; Cirule, Ieva; Sousa, Jaime Correia De; Costa, Elísio; Cvetkovski, Biljana; De Vries, Govert; Del Giacco, Stefano; Devillier, Philippe; Dokic, Dejan; Douagui, Habib; Durham, Stephen; Enecilla, Maria Lourdes; Fiocchi, Alessandro; Fokkens, Wytske; Fontaine, Jean-François; Gawlik, Radoslaw; Gereda, Jose E.; Mata, Sara GilAbstract The traditional healthcare model is focused on diseases (medicine and natural science) and does not acknowledge patients' resources and abilities to be experts in their own lives based on their lived experiences. Improving healthcare safety, quality, and coordination, as well as quality of life, is an important aim in the care of patients with chronic conditions. Person-centered care needs to ensure that people's values and preferences guide clinical decisions. This paper reviews current knowledge to develop (1) digital care pathways for rhinitis and asthma multimorbidity and (2) digitally enabled, person-centered care.1 It combines all relevant research evidence, including the so-called real-world evidence, with the ultimate goal to develop digitally enabled, patient-centered care. The paper includes (1) Allergic Rhinitis and its Impact on Asthma (ARIA), a 2-decade journey, (2) Grading of Recommendations, Assessment, Development and Evaluation (GRADE), the evidence-based model of guidelines in airway diseases, (3) mHealth impact on airway diseases, (4) From guidelines to digital care pathways, (5) Embedding Planetary Health, (6) Novel classification of rhinitis and asthma, (7) Embedding real-life data with population-based studies, (8) The ARIA-EAACI (European Academy of Allergy and Clinical Immunology) strategy for the management of airway diseases using digital biomarkers, (9) Artificial intelligence, (10) The development of digitally enabled, ARIA person-centered care, and (11) The political agenda. The ultimate goal is to propose ARIA 2024 guidelines centered around the patient to make them more applicable and sustainable.
- Management of allergic rhinitis symptoms in the pharmacy Pocket guide 2022Publication . Lourenço, Olga; Cvetkovski, Biljana; Kritikos, Vicky; House, Rachel; Scheire, Sophie; Costa, Elísio; Fonseca, Joao A; Menditto, Enrica; Bedbrook, Anna; Bialek, Slawomir; Briedis, Vitalis; Boussery, Koen; Canonica, G. Walter; Haahtela, Tari; Kuna, Piotr; Mullol, Joaquim; Orlando, Valentina; Samolinski, Boleslaw; Wallace, Dana; Duggan, Catherine; Paulino, Ema; Pinto, Gonçalo S.; Söderlund, Lars‐Åke; Bousquet, Jean; Bosnic‐Anticevich, SinthiaBackground: Allergic rhinitis (AR) management requires a coordinated effort from healthcare providers and patients. Pharmacists are key members of these integrated care pathways resolving medication-related problems, optimizing regimens, improving adherence and recommending therapies while establishing liaisons between patients and physicians. Methods: Allergic Rhinitis and its Impact on Asthma (ARIA) first published a reference document on the pharmacist's role in allergic rhinitis management in 2004. Several guidelines were developed over the past 20 years improving the care of allergic rhinitis patients through an evidence-based, integrated care approach. Results: This ARIA/EAACI/FIP Position Paper is based on the latest ARIA in the Pharmacy guidelines and provides: (a) a structured approach to pharmacists identifying people with AR and/or allergic conjunctivitis as well as those at risk of poor disease control; (b) an evidence-based clinical decision support tool for optimising the management of allergic rhinitis in the community pharmacy; and (c) a framework of referral to the physician. Conclusion: This document is not intended to be a mandatory standard of care but is provided as a basis for pharmacists and their staff to develop relevant local standards of care for their patients, within their local practice environment. Pharmacy care varies between countries, and the guide should be adapted to the local situation.
- Heterogeneity of the pharmacologic treatment of allergic rhinitis in Europe based on MIDAS and OTCims platformsPublication . Bousquet, Jean; Schröder-Bernhardi, Detlef; Bachert, Claus; Canonica, G Walter; Cardona, Victoria; Costa, Elísio; Czarlewski, Wienczyslawa; Devillier, Philippe; Fonseca, Joao A; Klimek, Ludger; Kuna, Piotr; Lourenço, Olga; Mullol, Joaquim; Pfaar, Oliver; Pham-Thi, Nhân; Samolinski, Boleslaw; Saueressig, Julia; Scadding, Glenis K; Stroh, Ann-Kathrin; Scheire, Sophie; Van Ganse, Eric; Zuberbier, TorstenBackground: The practice of allergology varies widely between countries, and the costs and sales for the treatment of rhinitis differ depending on practices and health systems. To understand these differences and their implications, the rhinitis market was studied in some of the EU countries. Methods: We conducted a pharmaco-epidemiological database analysis to assess the medications that were being prescribed for allergic rhinitis in the years 2016, 2017 and 2018. We used the IQVIA platforms for prescribed medicines (MIDAS®- Meaningful Integration of Data, Analytics and Services) and for OTC medicines (OTC International Market Tracking-OTCims). We selected the five most important markets in the EU (France, Germany, Italy, Poland and Spain). Results: Intranasal decongestants were excluded from the analyses because they are rarely prescribed for allergic rhinitis. For both Standard Units (SU) and costs, France is leading the other countries. In terms of SU, the four other countries are similar. For costs, Poland is lower than the three others. However, medication use differs largely. For 2018, in SU, intranasal corticosteroid is the first treatment in Poland (70.0%), France (51.3%), Spain (51.1%) and Germany (50.3%), whereas the Italian market is dominated by systemic antihistamines (41.4%) followed by intranasal corticosteroids (30.1%). Results of other years were similar. Discussion: There are major differences between countries in terms of rhinoconjunctivitis medication usage.
- ARIA-EAACI care pathways for allergen immunotherapy in respiratory allergyPublication . Bousquet, Jean; Pfaar, Oliver; Agache, Ioana; Bedbrook, Anna; Akdis, Cezmi; Canonica, Giorgio Walter; Chivato, Tomas; Al-Ahmad, Mona; Rasib, A. H. Abdul; Ansotegui Zubeldia, Ignacio Javier; Bachert, Claus; Ispayeva, Zhanat; Bosnic-Anticevich, Sinthia; Recto, Marysia; Valiulis, Arunas; Durham, Stephen L; Gereda, Jose E; Schünemann, Holger; Levin, Michael; Zernotti, Mario; Fauquert, Jean-Luc; Sofiev, Mikhail; Kowalski, Marek; Chkhartishvili, Ekaterine; Bindslev-Jensen, Carsten; Wagenmann, Martin; Fontaine, Jean-François; Heffler, Enrico; Soto-Martinez, Manuel; Mahboub, Bassam; Jutel, Marek; Gerth Van Wijk, Roy; Lauerma, Antti; Ebisawa, Motohiro; Casale, Thomas; Bosse, Isabelle; Grisle, Ineta; Julge, Kaja; Barata, Luís Taborda; Meltzer, Eli O; Caraballo, Luis; Hoffmann-Sommergruber, Karin; Gawlik, Radoslaw; Devillier, Philippe; Chu, Derek K; Irani, Carla; Kraxner, Helga; Toppila-Salmi, Sanna; Montefort, Stephen; Nekam, Kristof; Kaidashev, Igor; Guzman, Maria Antonieta; El-Gamal, Yehia; Klimek, Ludger; Lau, Susanne; Valovirta, Erkka; Mullol, Joaquim; Palomares, Oscar; Ollert, Markus; O'Hehir, Robyn; Gelincik, Asli; Kvedarienė, Violeta; Wallace, Dana; Okubo, Kimihiro; Bergmann, Karl-Christian; Park, Hae-Sim; Papadopoulos, Nikolaos G.; Haahtela, Tari; Linnemann, Désirée Larenas; Wong, Gary Wk; Pham-Thi, Nhân; Martins, Pedro Carreiro; Regateiro, Frederico S.; Ivancevich, Juan Carlos; Malling, Hans-Jørgen; Zhang, Luo; Rottem, Menachem; Demoly, Pascal; Samoliński, Bolesław; Knol, Edward; Miculinic, Neven; Brough, Helen; Fiocchi, Alessandro; Sheikh, Aziz; Kritikos, Vicky; Almeida, Mário Morais; Cirule, Ieva; Gomez, R Maximiliano; Soto-Quiros, Manuel; Lodrup Carlsen, Karin C; Namazova-Baranova, Leyla; Ėmužytė, Regina; Bom, Ana Todo; Manning, Patrick; Pajno, Giovanni B; Gemicioglu, Bilun; Tsiligianni, Ioanna; Milenkovic, Branislava; Plavec, Davor; Halken, Susanne; Skypala, Isabel; O'Mahony, Liam; Fokkens, Wytske J; Lombardi, Carlo; Riggioni, Carmen; Shamji, Mohamed; Hossny, Elham; Vandenplas, Olivier; Mortz, Charlotte G; Rouadi, Philip; Tomazic, Peter Valentin; Passalacqua, Giovanni; Odemyr, Mikaëla; Marshall, Gailen D; Sanchez-Borges, Mario; Solé, Dirceu; Kalayci, Omer; Walusiak-Skorupa, Jolanta; Neffen, Hugo; Schmid-Grendelmeier, Peter; Roberts, Graham; Panzner, P.; Ohta, Ken; Scichilone, Nicola; Suppli-Ulrik, Charlotte; Kull, Inger; Yorgancıoglu, Arzu; Baharuddin, Abdullah; Sooronbaev, Talant; Serpa, Faradiba S; Patella, Vincenzo; Sova, Milan; Valero, Antonio; Laune, Daniel; Zidarn, Mihaela; Cardona, Victoria; Bonini, Matteo; Bjermer, Leif; Rodriguez-Gonzales, Monica; Torres, Maria J; Lourenço, Olga; Brussino, Luisa; Del Giacco, Stefano; Cepeda Sarabia, Alfonso M; Cecchi, Lorenzo; Sastre, Joaquin; Untersmayr, Eva; Melén, Erik; Cruz, Alvaro A; Niedoszytko, Marek; Dokic, Dejan; Sisul, Juan; Ventura, Maria Teresa; Moin, Mostafa; Gamkrelidze, Amiran; Palkonen, Susanna; Fonseca, Joao A; Schwarze, Jürgen; Wang, De Yun; Mösges, Ralph; Popov, Todor A; Gotua, Maia; Valentin Rostan, Marylin; Yusuf, Osman; Okamoto, Yoshitaka; Ryan, Dermot; Hrubiško, Martin; Urrutia-Pereira, Marilyn; Zuberbier, Torsten; Pawankar, Ruby; Khaitov, Musa; Vichyanond, Pakit; Calderon, Moises A; Rosário, Nelson; Kuna, Piotr; Waserman, Susan; Czarlewski, Wienczyslawa; Scadding, Glenis KAllergen immunotherapy (AIT), the gradually increasing repeated administration of high doses of allergens to allergic patients, offers the potential for immune tolerance against reactions to the natural exposures to specific allergens. AIT may lead to the long‐lasting remission of allergic symptoms and is the only disease‐modifying intervention in IgE‐mediated allergic respiratory diseases. [...]