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- Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technologyPublication . Bousquet, Jean; Hellings, Peter; Agache, Ioana; Amat, Flore; Annesi-Maesano, Isabella; Ansotegui, Ignacio J; Anto, Josep M; Bachert, Claus; Bateman, Eric D; Bedbrook, Anna; Bennoor, Kazi Saifuddin; Rottem, Menachem; Ryan, Dermot; Salimäki, Johanna; Samolinski, Boleslaw; Sanchez-Borges, Mario; Schunemann, Holger J; Sisul, Juan; Rajabian-Söderlund, Rojin; Sooronbaev, Talant; Stellato, Cristiana; To, Teresa; Sheikh, Aziz; Todo-Bom, Ana; Tomazic, Peter Valentin; Toppila-Salmi, Sanna; Valero, Antonio; Valiulis, Arunas; Ventura, Maria Teresa; Wagenmann, Martin; Wang, De Yun; Wallace, Dana; Waserman, Susan; Valovirta, Erkka; Wickman, Magnus; Yorgancioglu, Arzu; Zhang, Luo; Zhong, Nanshan; Zidarn, Mihaela; Bewick, Mickael; Bindslev-Jensen, Carsten; Bosnic-Anticevich, Sinthia; Bosse, Isabelle; Brozek, Jan; Zuberbier, Torsten; Brussino, Luisa; Canonica, Giorgio W; Cardona, Victoria; Casale, Thomas; Sarabia, Alfonso M Cepeda; Chavannes, Niels H; Sousa, Jaime Correia de; Costa, Elísio; Cruz, Alvaro A; Czarlewski, Wienczyslawa; Cecchi, Lorenzo; De Carlo, Giuseppe; De Feo, Giulia; Demoly, Pascal; Devillier, Philippe; Dykewicz, Mark S; El-Gamal, Yehia; Fonseca, Joao A; Fontaine, Jean-François; Fokkens, Wytske J; Guzman, Maria Antonieta; Eller, Esben E; Haahtela, Tari; Illario, Maddalena; Ivancevich, Juan-Carlos; Just, Jocelyne; Kaidashev, Igor; Khaitov, Musa; Keil, Thomas; Klimek, Ludger; Kowalski, Marek L; Kuna, Piotr; Kalayci, Omer; Kvedarienė, Violeta; Larenas Linnemann, Désirée; Laune, Daniel; Le Thi Tuyet, Lan; Carlsen, Karin Lodrup; Lourenço, Olga; Mair, Alpana; Menditto, Enrica; Milenkovic, Branislava; Morais-Almeida, Mario; Mahboub, Bassam; Mösges, Ralph; Mullol, Joaquim; Murray, Ruth; Naclerio, Robert; Namazova-Baranova, Leyla; Novellino, Ettore; Ohta, Ken; Okamoto, Yoshitaka; Okubo, Kimihiro; Onorato, Gabrielle L; O'Hehir, Robyn; Palkonen, Susanna; Panzner, Petr; Papadopoulos, Nikos G; Park, Hae-Sim; Paulino, Ema; Pawankar, Ruby; Plavec, Davor; Popov, Ted A; Potter, Paul; Prokopakis, Emmanuel P; Pfaar, OliverAllergic 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.
- ARIA pharmacy 2018: Allergic rhinitis care pathways for community pharmacyPublication . 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, RubyPharmacists 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.
- MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidencePublication . Bousquet, Jean; Arnavielhe, S; Bedbrook, Anna; Bewick, M; Laune, Daniel; Mathieu-Dupas, Eve; Murray, R; Onorato, G L; Pépin, J L; Picard, Robert; Portejoie, F; Costa, E; Fonseca, J; Lourenço, Olga; Almeida, M Morais; Todo-Bom, Ana; Cruz, A A; Silva, J da; Serpa, F S; Illario, Maddalena; Menditto, E; Cecchi, Lorenzo; Monti, R; Napoli, Luigi; Ventura, Maria Teresa; De Feo, G; Linnemann, Désirée Larenas; Fuentes Perez, M; Huerta Villabolos, Y R; Rivero-Yeverino, D; Rodriguez-Zagal, E; Amat, F; Annesi-Maesano, I; Bosse, I; Demoly, P; Devillier, P; Fontaine, J F; Just, Jocelyne; Kuna, T P; Samolinski, Boleslaw; Valiulis, Arunas; Emuzyte, R; Kvedarienė, Violeta; Ryan, D; Sheikh, A; Schmidt-Grendelmeier, P; Klimek, L; Pfaar, Oliver; Bergmann, Karl-Christian; Mösges, R; Zuberbier, T; Roller-Wirnsberger, R E; Tomazic, Peter Valentin; Fokkens, W J; Chavannes, N H; Reitsma, S; Anto, Josep M.; Cardona, V; Dedeu, T; Mullol, J; Haahtela, Tari; Salimäki, Johanna; Toppila-Salmi, S; Valovirta, Erkka; Gemicioglu, Bilun; Yorgancioglu, A; Papadopoulos, N; Prokopakis, E P; Bosnic-Anticevich, S; O'Hehir, Robyn; Ivancevich, J C; Neffen, Hugo; Zernotti, E; Kull, Inger; Melén, Erik; Wickman, M; Bachert, Claus; Hellings, Peter; Palkonen, S; Bindslev-Jensen, C; Eller, E; Waserman, S; Sova, M; De Vries, G; Van Eerd, Michiel; Agache, Ioana; Casale, Thomas; Dykewickz, M; Naclerio, Robert; Okamoto, Yoshitaka; Wallace, D VmHealth, such as apps running on consumer smart devices is becoming increasingly popular and has the potential to profoundly affect healthcare and health outcomes. However, it may be disruptive and results achieved are not always reaching the goals. Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline using the best evidence-based approach to care pathways suited to real-life using mobile technology in allergic rhinitis (AR) and asthma multimorbidity. Patients largely use over-the-counter medications dispensed in pharmacies. Shared decision making centered around the patient and based on self-management should be the norm. Mobile Airways Sentinel networK (MASK), the Phase 3 ARIA initiative, is based on the freely available MASK app (the Allergy Diary, Android and iOS platforms). MASK is available in 16 languages and deployed in 23 countries. The present paper provides an overview of the methods used in MASK and the key results obtained to date. These include a novel phenotypic characterization of the patients, confirmation of the impact of allergic rhinitis on work productivity and treatment patterns in real life. Most patients appear to self-medicate, are often non-adherent and do not follow guidelines. Moreover, the Allergy Diary is able to distinguish between AR medications. The potential usefulness of MASK will be further explored by POLLAR (Impact of Air Pollution on Asthma and Rhinitis), a new Horizon 2020 project using the Allergy Diary.
- Rhinitis associated with asthma is distinct from rhinitis alone: TARIA‐MeDALL hypothesisPublication . Bousquet, Jean; Melén, Erik; Haahtela, Tari; Koppelman, Gerard; Togias, Alkis; Valenta, Rudolf; Akdis, Cezmi; Czarlewski, Wienczyslawa; Rothenberg, Marc; Valiulis, Arunas; Wickman, Magnus; Aberer, Werner; Heinrich, Joachim; Sisul, Juan; Nunes, Elizabete; Plavec, Davor; Agache, Ioana; Al-Ahmad, Mona; Serpa, Faradiba; Alobid, Isam; Kalayci, Omer; Vichyanond, Pakit; Giacco, S. Del; Fiocchi, Alessandro; Ansotegui Zubeldia, Ignacio Javier; Custovic, Adnan; Martins, Pedro Carreiro; Rouadi, Philip; Arshad, Syed Hasan; Asayag, Estrella; Bárbara, Cristina; Abdullah, Baharudin; Moniuszko, Marcin; Tomazic, Peter Valentin; Popov, T. A.; Sayah, Zineb; Lkhagvaa, Battur; Nyembue Tshipukane , Dieudonne; Thomas, Mike; Bennoor, Kazi Saifuddin; Fyhrquist, Nanna Theresia; Irani, Carla; Berghea, Elena Camelia; Ėmužytė, Regina; De Blay, Frédéric; Toppila-Salmi, Sanna Katriina; Bergmann, Karl-Christian; Bernstein, D.; Bewick, M.; Casale, Thomas; Scheire, Sophie; Bumbacea, Roxana Silvia; Cepeda Sarabia, Alfonso; Puggioni, Francesca; Bush, Andrew; Chandrasekharan, Ramanathan; Ohta, Ken; Okubo, Kimihiro; Charpin, Denis; Gomez, R Maximiliano; Chen, Y. Z.; O'Hehir, Robyn; Cherrez Ojeda, Ivan; Bedbrook, Anna; To, Teresa; Chu, Derek K; Devillier, Philippe; Schmid-Grendelmeier, Peter; Didier, Alain; Repka-Ramirez, María Susana; Teixeira, Maria Do Céu; Ispayeva, Zhanat; Dokic, Dejan; Quirce, Santiago; Douagui , Habib; Ivancevich, Juan Carlos; Viegi, Giovanni; Gotua, Maia; Todo-Bom, Ana; Blain, Hubert; Guzman, Maria Antonieta; Kalyoncu, Ali Fuat; Hagemann, Jan; Buhl, Roland; Hamamah, Samir; Caraballo, Luis; Jares, Edgardo; Wallace, Dana; Chivato, Tomás; Jartti, Tuomas; Jassem, Ewa; Christoff, George; Julge, Kalev; Ogulur, Ismail; Kardas, Przemyslaw; Doulaptsi, Maria; Kirenga, Bruce; Helga, Kraxner; Durham, Stephen; Kull, Inger; Kulus, Marek; Daniel, Aguilar; Shamji, Mohamed; Kuna, Piotr; Nadif, Rachel; La Grutta, Stefania; Brightling, Chris; Samoliński, Bolesław; Lau, Susanne; Wang, De Yun; Cordeiro, Carlos Manuel Da Silva Robalo; Solé, Dirceu; Le Thi Tuyet, Lan; Recto, Marysia; Ouedraogo, Solange; Halken, Susanne; Levin, Michael; Lipworth, Brian; Lourenço, Olga; Mahboub, Bassam; Vandenplas, O.; Niedoszytko, Marek; Sastre, Joaquin; Martinez‐Infante, E.; Kupczyk, Maciej; Torres, María Jose; Matricardi, Paolo Maria; Cecchi, Lorenzo; Celedón, Juan C; Miculinic, Neven; Roche, Nicolas; Just, Jocelyne; Migueres, Nicolas; Brussino, Luisa; Florin, Mihaltan; Olze, Heidi; Savouré, Marine; Nekam, Kristof; Pali, Isabella; Okamoto, Yoshitaka; Palomares, O.; Lemonnier, Nathanaël; Carlsen, Karin C. Lodrup; Palosuo, Kati; Soto-Martinez, Manuel; Panaitescu, Carmen; Kvedarienė, Violeta; Panzner, P.; Braido, Fulvio; Tsiligianni, Ioanna; Rodriguez-Gonzalez, Monica; Scichilone, Nicola; Canonica, Giogio Walter; Passalacqua, Giovanni; Romantowski, Jan; Urrutia-Pereira, Marilyn; Filho, Nelson Augusto Rosario; Ollert, Markus W.; Rottem, Menachem; Chkhartishvili, Ekaterine; Sova, Milan; Valovirta, Erkka; Mohammad, Yousser; Sperl, Annette; Williams, Siân; Spranger, Otto; Neffen, Hugo; Stelmach, Rafael; Burte, Emilie; Valentin Rostan, Marylin; Park, Hae-Sim; Van Ganse, Eric; Van Hage, Marianne; Pitsios, Constantinos; Vasankari, Tuula; Linnemann, Désirée Larenas; Loureiro, Cláudia Chaves; Sagara, Hironori; Worm, Margitta; Yiallouros, Panayiotis; Yusuf, Osman; Zaitoun, Fares; Bonini, Matteo; Hrubiško, Martin; Cingi, C.; Dykewicz, Mark; Zernotti, Mario; Calderon, Moises; Halpin, David M.G.; Zidarn, Mihaela; Patella, Vincenzo; Sheikh, Aziz; Zuberbier, Jaron; Papadopoulos, Nikolaos; Louis, Renaud; Suppli Ulrik, Charlotte; Fonseca, João P.; Zuberbier, Torsten; Anto, Josep M.; Costa, Elisio; Eiwegger, Thomas; Bosnic-Anticevich, Sinthia; Cruz, Alvaro; Sousa, Jaime Correia de; Louis-Philippe, Boulet; Erhola, Marina; Cardona, Victoria; Carr, Warner; Gemicioglu, Bilun; Pawankar, Ruby; Fokkens, Wytske; Calvo, Mário; Garcia-Aymerich, J.; Mäkelä, Mika J.; Hofmann, Maja Ann; Klimek, Ludger; Makris, Michael; Mohamed Sayed, Zeinab; Maurer, Marcus; D'Amato, G.; Momas, Isabelle; Siroux, Valérie; Almeida, Mário Morais; Corrigan, Chris; Mullol, Joaquim; Montefort, Stephen; Jutel, Marek; Pham Thi, Nhan; Hossny, Elham; Akdis, Mubeccel; Pfaar, Oliver; Ventura, Maria Teresa; Regateiro, Frederico S.; Bindslev-Jensen, Carsten; Ring, Johannes; Bustamante, Mariona; Pinto, Bernardo Sousa; Kaidashev, Igor; Guerra, Stefano; Standl, Marie; Sunyer, J.; Keil, Thomas; Barata, Luís Taborda; Camargos, Paulo; Weiss, Scott; Naclerio, Robert; Yorgancıoglu, Arzu; Zhang, Luo; Nadeau, Kari; Abdul Latiff, AmirAsthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of “one-airway-one-disease,” coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the “Epithelial Barrier Hypothesis.” This review determined that the “one-airway-one-disease” concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme “allergic” (asthma) phenotype combining asthma, rhinitis, and conjunctivitis.