Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

Abstract

Background In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care. Conclusion In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.

Managing Allergic Rhinitis in the Pharmacy: An ARIA Guide for Implementation in Practice

“…MASK was proposed to be the mHealth strategy of AIRWAYS ICPs. MASK was developed as a proof-of-concept for multimorbid chronic disease care across the life cycle [28,29] and is scaled up using the EIP on AHA strategy [30,31]. It is a Good Practice of DG Santé [25,32] (digitally enabled, integrated, person-centred care for rhinitis and asthma) for change management [33].…”

ARIA guideline 2019: treatment of allergic rhinitis in the German health system

“…New guidelines for pharmacotherapy and ICPs for allergen-specific immunotherapy (AIT) are currently being developed for allergic rhinitis (AR). Following the Paris meeting, two separate documents were produced [28,29]. The present publication is a summary Fig.…”

Allergen immunotherapy: what is the added value of real-world evidence from retrospective claims database studies?

“…Because Allergy Diary (MASKair®) can distinguish between AR medications and record data on nonprescription medication use, it provides detailed and useful information on AR treatment, enabling the assessment of real-life treatment patterns. Real-life data collected from~10,000 users of Allergy Diary (MASKair®) worldwide show that most patients are not being treated according to guidelines and often self-medicate [38][39][40].…”

“…Using RWE gathered by Allergy Diary (MASKair®) and other digital health apps and tools, the Mobile Airways Sentinel NetworK (MASK), a collaborative effort by the Allergic Rhinitis and its Impact on Asthma (ARIA) initiative, and professional and patient organizations in allergy and airway diseases, has proposed real-life integrated care pathways for individuals with AR [40]. To strengthen the conclusions drawn from real-world data, ARIA have proposed that Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria are applied to RWE.…”

“…To strengthen the conclusions drawn from real-world data, ARIA have proposed that Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria are applied to RWE. Moreover, they advise that next-generation guidelines for AR and asthma should include testing, refinement, and confirmation of guideline recommendations based on RWE in combination with the GRADE approach [40].…”