Digital technologies for an improved management of respiratory allergic diseases: 10 years of clinical studies using an online platform for patients and physicians

Abstract

Background: Digital health technologies carry the great potential of assisting physicians in making well-informed diagnostic and therapeutic decisions. In allergy care, electronic clinical diaries have been recently used to prospectively collect patient data and improve diagnostic precision. Objective: This review summarizes the clinical and scientific experience we gathered over 10 years of using a digital platform for patients suffering from seasonal allergic rhinitis. Methods: The mobile application and back-office of AllergyMonitor (TPS software production, Rome, Italy) enable patients to record their daily allergy symptoms as well as drug and immunotherapy intake plus possible side effects in a customizable way. The results can be accessed by the patient and attending physician as concise reports via a smartphone or computer. This technology has been used in several clinical studies and routine practice since 2009. Results: Our studies showed that A) the etiological diagnosis of SAR may be supported by matching prospectively registered symptoms with pollen counts; B) it is possible to perform a short-term prediction of SAR-symptoms at individual level; C) the adherence to daily symptom monitoring can remain high (> 80%) throughout several weeks when prescribed and thoroughly explained by the treating doctor; D) the use of mobile technology can improve adherence to symptomatic drugs as well as allergen-specific immunotherapy and E) the choice of the correct symptom-severity-score is critical at patient level, but not at group level. Conclusion: The studies and clinical practice based on the use of AllergyMonitor have proven the reliability and positive impact of a digital platform including an electronic diary (eDiary) on the diagnostic precision of SAR in poly-sensitized patients as well as patient adherence to both, drug therapy and allergen immunotherapy.

@IT2020: An innovative algorithm for allergen immunotherapy prescription in seasonal allergic rhinitis

“…However, electronic clinical diaries (eDiaries) are useful for real-time prospective symptom monitoring [12][13][14][15][16] and enable doctors to evaluate individual symptoms and the need for medication. With the help of software systems, clinical scores can be automatically generated, graphically matching patients´ combined symptom and medication score (CSMS) trajectories with those of the local allergen counts.…”

“…In contrast, a great variety of mobile phone applications—most of which not yet validated—has flooded the market, aiming at an improved disease control and quality of life for allergic patients. However, electronic clinical diaries (eDiaries) are useful for real‐time prospective symptom monitoring 12‐16 and enable doctors to evaluate individual symptoms and the need for medication. With the help of software systems, clinical scores can be automatically generated, graphically matching patients´ combined symptom and medication score (CSMS) trajectories with those of the local allergen counts 16,17 …”

Heterogeneous validity of daily data on symptoms of seasonal allergic rhinitis recorded by patients using the e‐diary AllergyMonitor®

“…To enable an informed and shared clinical decision‐making, a standardized assessment of disease severity and control is usually performed retrospectively using validated questionnaires and criteria, such as the widely applied allergic rhinitis and its impact on asthma (ARIA) guidelines 10 . Recently, several digital and mobile health technologies have been proposed to facilitate the prospective real‐time collection of patient‐generated data on symptom severity, medication intake or allergen exposure 11–15 . Patients are being asked to enter their clinical symptoms mainly via user‐friendly electronic diaries (e‐diary) while exposure data are being collected through national or local pollen monitoring stations or networks.…”

Developments in pediatrics in 2020: choices in allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, ortopedics, respiratory tract illnesses and rheumatology

“…A new mobile diary app with the platform “AllergyMonitor” simultaneously provided pollen concentrations. Digital technology was helpful for virtual assessment of children with allergic rhinitis due to pollen allergy by improving symptom prediction, selection of allergen immunotherapy composition aeroallergens [ 22 ], and adherence to treatment [ 23 ].…”