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

Author

J. Jean Bousquet, Holger J. Schünemann, Alkis Togias, Marina Erhola, Peter W. Hellings, Torsten Zuberbier, Ioana Agache, Ignacio J. Ansotegui, Josep M. Anto, Claus Bachert, Sven Becker, Martin Bedolla-Barajas, Michael Bewick, Sinthia Bosnic-Anticevich, Isabelle Bosse, Louis P. Boulet, Jean Marc Bourrez, Guy Brusselle, Niels Chavannes, Elisio Costa, Alvaro A. Cruz, Wienczyslawa Czarlewski, Wytske J. Fokkens, Joao A. Fonseca, Mina Gaga, Tari Haahtela, Maddalena Illario, Ludger Klimek, Piotr Kuna, Violeta Kvedariene, L. T. T. Le, Desiree Larenas-Linnemann, Daniel Laune, Olga M. Lourenço, Enrica Menditto, Joaquin Mullol, Yashitaka Okamoto, Nikos Papadopoulos, Nhân Pham-Thi, Robert Picard, Hilary Pinnock, Nicolas Roche, Regina E. Roller-Wirnsberger, Christine Rolland, Boleslaw Samolinski, Aziz Sheikh, Sanna Toppila-Salmi, Ioanna Tsiligianni, Arunas Valiulis, Erkka Valovirta, Tuula Vasankari, Maria-Teresa Ventura, Samantha Walker, Sian Williams, Cezmi A. Akdis, Isabella Annesi-Maesano, Sylvie Arnavielhe, Xavier Basagana, Eric Bateman, Anna Bedbrook, K. S. Bennoor, Samuel Benveniste, Karl C. Bergmann, Slawomir Bialek, Nils Billo, Carsten Bindslev-Jensen, Leif Bjermer, Hubert Blain, Mateo Bonini, Philippe Bonniaud, Jacques Bouchard, Vitalis Briedis, Christofer E. Brightling, Jan Brozek, Roland Buhl, Roland Buonaiuto, Giorgo W. Canonica, Victoria Cardona, Ana M. Carriazo, Warner Carr, Christine Cartier, Thomas Casale, Lorenzo Cecchi, Alfonso M. Cepeda Sarabia, Eka Chkhartishvili, Derek K. Chu, Cemal Cingi, Elaine Colgan, Jaime Correia de Sousa, Anne Lise Courbis, Adnan Custovic, Biljana Cvetkosvki, Gennaro D’Amato, Jane da Silva, Carina Dantas, Dejand Dokic, Yves Dauvilliers, Antoni Dedeu, Giulia De Feo, Philippe Devillier, Stefania Di Capua, Marc Dykewickz, Ruta Dubakiene, Motohiro Ebisawa, Yaya El-Gamal, Esben Eller, Regina Emuzyte, John Farrell, Antjie Fink-Wagner, Alessandro Fiocchi, Jean F. Fontaine, Bilun Gemicioğlu, Peter Schmid-Grendelmeir, Amiran Gamkrelidze, Judith Garcia-Aymerich, Maximiliano Gomez, Sandra González Diaz, Maia Gotua, Nick A. Guldemond, Maria-Antonieta Guzmán, Jawad Hajjam, John O’B Hourihane, Marc Humbert, Guido Iaccarino, Despo Ierodiakonou, Juan C. Ivancevich, Guy Joos, Ki-Suck Jung, Marek Jutel, Igor Kaidashev, Omer Kalayci, Przemyslaw Kardas, Thomas Keil, Mussa Khaitov, Nikolai Khaltaev, Jorg Kleine-Tebbe, Marek L. Kowalski, Vicky Kritikos, Inger Kull, Lisa Leonardini, Philip Lieberman, Brian Lipworth, Karin C. Lodrup Carlsen, Claudia C. Loureiro, Renaud Louis, Alpana Mair, Gert Marien, Bassam Mahboub, Joao Malva, Patrick Manning, Esteban De Manuel Keenoy, Gailen D. Marshall, Mohamed R. Masjedi, Jorge F. Maspero, Eve Mathieu-Dupas, Poalo M. Matricardi, Eric Melén, Elisabete Melo-Gomes, Eli O. Meltzer, Jacques Mercier, Neven Miculinic, Florin Mihaltan, Branislava Milenkovic, Giuliana Moda, Maria-Dolores Mogica-Martinez, Yousser Mohammad, Steve Montefort, Ricardo Monti, Mario Morais-Almeida, Ralf Mösges, Lars Münter, Antonella Muraro, Ruth Murray, Robert Naclerio, Luigi Napoli, Leila Namazova-Baranova, Hugo Neffen, Kristoff Nekam, Angelo Neou, Enrico Novellino, Dieudonné Nyembue, Robin O’Hehir, Ken Ohta, Kimi Okubo, Gabrielle Onorato, Solange Ouedraogo, Isabella Pali-Schöll, Susanna Palkonen, Peter Panzner, Hae-Sim Park, Jean-Louis Pépin, Ana-Maria Pereira, Oliver Pfaar, Ema Paulino, Jim Phillips, Davor Plavec, Ted A. Popov, Fabienne Portejoie, David Price, Emmanuel P. Prokopakis, Benoit Pugin, Filip Raciborski, Rojin Rajabian-Söderlund, Sietze Reitsma, Xavier Rodo, Antonino Romano, Nelson Rosario, Menahenm Rottem, Dermot Ryan, Johanna Salimäki, Mario M. Sanchez-Borges, Juan-Carlos Sisul, Dirceu Solé, David Somekh, Talant Sooronbaev, Milan Sova, Otto Spranger, Cristina Stellato, Rafael Stelmach, Charlotte Suppli Ulrik, Michel Thibaudon, Teresa To, Ana Todo-Bom, Peter V. Tomazic, Antonio A. Valero, Rudolph Valenta, Marylin Valentin-Rostan, Rianne van der Kleij, Olivier Vandenplas, Giorgio Vezzani, Frédéric Viart, Giovanni Viegi, Dana Wallace, Martin Wagenmann, De Y. Wang, Susan Waserman, Magnus Wickman, Dennis M. Williams, Gary Wong, Piotr Wroczynski, Panayiotis K. Yiallouros, Arzu Yorgancioglu, Osman M. Yusuf, Heahter J. Zar, Stéphane Zeng, Mario Zernotti, Luo Zhang, Nan S. Zhong, Mihaela Zidarn, the ARIA Study Group, and the MASK Study Group

Subjects
Health care transformation, Care pathways, Rhinitis, ARIA, MASK, POLLAR, Immunologic diseases. Allergy, RC581-607
Abstract

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.

Published
2019
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2. ARIA pharmacy 2018 'Allergic rhinitis care pathways for community pharmacy' AIRWAYS ICPs initiative (European Innovation Partnership on Active and Healthy Ageing, DG CONNECT and DG Sante) \nPOLLAR (Impact of Air POLLution on Asthma and Rhinitis)\nGARD Demonstration project

Author

Karin C. Lødrup Carlsen, Ralph Mösges, María Antonieta Guzmán, Bolesław Samoliński, Olga Lourenço, Mario Sánchez-Borges, Giuseppe De Carlo, Violeta Kvedariene, Errka Valovirta, Mario E. Zernotti, Osman M. Yusuf, Juan Carlos Sisul, Ana Todo-Bom, Enrica Menditto, Robyn E O'Hehir, Yoshitaka Okamoto, Joaquim Mullol, Aziz Sheikh, Johanna Salimäki, Bassam Mahboub, P. Manning, Petr Panzner, Vicky Kritikos, Susan Waserman, Désirée Larenas-Linnemann, Kimi Okubo, Todor A. Popov, Juan Carlos Ivancevich, W. Carr, Elísio Costa, Davor Plavec, Vitalis Briedis, Piotr Wroczyński, Teresa To, Regina Roller-Wirnsberger, Nikolaos G. Papadopoulos, Torsten Zuberbier, Heather J. Zar, João Fonseca, Ioana Agache, Valentina Orlando, Holger J. Schünemann, Slawomir Bialek, Dermot Ryan, Ettore Novellino, Peter Hellings, Ema Paulino, Rojin Söderlund, Susanna Palkonen, Biljana Cvetkovski, Cristiana Stellato, Henry Chrystyn, Piotr Kuna, Mihaela Zidarn, Kristof Nekam, Carsten Bindslev-Jensen, Jean Bousquet, Tari Haahtela, Josep M. Antó, Arzu Yorgancioglu, Stefania Di Capua, Sinthia Bosnic-Anticevich, Dieter Maier, Ignacio J. Ansotegui, Alpana Mair, Lars Münter, Martin Wagenmann, L. T. T. Le, Jim Phillips, Marek L. Kowalski, David Somekh, Thomas B. Casale, M. Bewick, Jan Brozek, Menachem Rottem, Wienczyslawa Czarlewski, Ken Ohta, Jocelyne Just, Ludger Klimek, Mark S. Dykewicz, Peter Valentin Tomazic, Maddalena Illario, Philippe Devillier, Nikolai Khaltaev, Leyla Namazova-Baranova, Roland Buonaiuto, Pascal Demoly, Niels H. Chavannes, Wytske Fokkens, Alvaro A. Cruz, Robert M. Naclerio, Emmanuel P. Prokopakis, Anna Bedbrook, Panayiotis K. Yiallouros, Dana Wallace, Sanna Toppila-Salmi, Daniel Laune, Magnus Wickman, Igor Kaidashev, Yehia El-Gamal, Hae-Sim Park, Mário Morais-Almeida, Musa Khaitov, Giorgio Walter Canonica, Antonio Valero, Arunas Valiulis, Ruth Murray, Claus Bachert, Maria Teresa Ventura, Paul C. Potter, Gabrielle L. Onorato, Victoria Cardona, Jaime Correia de Sousa, Oliver Pfaar, Mina Gaga, Rachel Tan, João O. Malva, Thomas Keil, Ruby Pawankar, Luo Zhang, Tshipukane Dieudonné Nyembue, Dennis M. Williams, HUS Inflammation Center, Department of Dermatology, Allergology and Venereology, University of Helsinki, and Department of Pathology

Subjects
0301 basic medicine, IMPACT, pharmacist, Psychological intervention, Pharmacists, Medical and Health Sciences, 0302 clinical medicine, QUALITY-OF-LIFE, Health care, Immunology and Allergy, Public Health Surveillance, Community Health Services, MASK-RHINITIS, Rhinitis, Disease Management, Telemedicine, 3. Good health, care pathways, SUBLINGUAL IMMUNOTHERAPY, 317 Pharmacy, Care pathways, Critical Pathways, Pharmacist, Symptom Assessment, medicine.medical_specialty, Referral, Immunology, education, Pharmacy, VALIDATION, Medication Adherence, MACVIA-ARIA, 03 medical and health sciences, INTERMITTENT, Professional Role, Quality of life (healthcare), rhinitis, medicine, MANAGEMENT, Humans, Asthma, Pharmacies, ARIA, business.industry, Decision Support Systems, Clinical, medicine.disease, Rhinitis, Allergic, Allergic Rhinitis and its Impact on Asthma, Integrated care, 030104 developmental biology, SEVERITY, 030228 respiratory system, 13. Climate action, Family medicine, 3121 General medicine, internal medicine and other clinical medicine, UPDATE, Clinical Medicine, business
Abstract

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. ispartof: ALLERGY vol:74 issue:7 pages:1219-1236 ispartof: location:Denmark status: published

Published
2019

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