Treatment of allergic rhinitis using mobile technology with real-world data: The MASK observational pilot study

J Bousquet; P Devillier; S Arnavielhe; A Bedbrook; G Alexis-Alexandre; M van Eerd; R Murray; G W Canonica; M Illario; E Menditto; G Passalacqua; C Stellato; M Triggiani; P Carreiro-Martins; J Fonseca; M Morais Almeida; L Nogueira-Silva; A M Pereira; A Todo Bom; I Bosse; D Caimmi; P Demoly; J F Fontaine; J Just; G L Onorato; M L Kowalski; P Kuna; B Samolinski; J M Anto; J Mullol; A Valero; P V Tomazic; K C Bergmann; T Keil; L Klimek; R Mösges; S Shamai; T Zuberbier; E Murphy; P McDowall; D Price; D Ryan; A Sheikh; N H Chavannes; W J Fokkens; V Kvedariene; A Valiulis; C Bachert; P W Hellings; I Kull; E Melen; M Wickman; C Bindslev-Jensen; E Eller; T Haahtela; N G Papadopoulos; I Annesi-Maesano; M Bewick; S Bosnic-Anticevich; A A Cruz; G De Vries; B Gemicioglu; D Larenas-Linnemann; D Laune; E Mathieu-Dupas; R E O'Hehir; O Pfaar; F Portejoie; V Siroux; O Spranger; E Valovirta; O VandenPlas; A Yorgancioglu

doi:10.1111/all.13406

Treatment of allergic rhinitis using mobile technology with real-world data: The MASK observational pilot study

Allergy. 2018 Sep;73(9):1763-1774. doi: 10.1111/all.13406. Epub 2018 Mar 22.

Authors

J Bousquet^{1

2

3}, P Devillier⁴, S Arnavielhe⁵, A Bedbrook¹, G Alexis-Alexandre⁶, M van Eerd⁷, R Murray⁸, G W Canonica⁹, M Illario¹⁰, E Menditto¹¹, G Passalacqua⁹, C Stellato¹², M Triggiani¹², P Carreiro-Martins¹³, J Fonseca^{14

15}, M Morais Almeida¹⁶, L Nogueira-Silva¹⁷, A M Pereira^{15

18

19}, A Todo Bom²⁰, I Bosse²¹, D Caimmi²², P Demoly²², J F Fontaine²³, J Just²⁴, G L Onorato¹, M L Kowalski^{25

26}, P Kuna²⁷, B Samolinski²⁸, J M Anto^{29

30

31

32}, J Mullol¹⁶, A Valero³³, P V Tomazic³⁴, K C Bergmann³⁵, T Keil^{36

37}, L Klimek³⁸, R Mösges^{39

40}, S Shamai^{39

40}, T Zuberbier³⁵, E Murphy⁴¹, P McDowall⁴¹, D Price^{42

43

44}, D Ryan⁴⁵, A Sheikh⁴⁶, N H Chavannes⁴⁷, W J Fokkens⁴⁸, V Kvedariene⁴⁹, A Valiulis^{50

51}, C Bachert⁵², P W Hellings^{3

53

54}, I Kull⁵⁵, E Melen⁵⁵, M Wickman^{56

57}, C Bindslev-Jensen⁵⁸, E Eller⁵⁸, T Haahtela⁵⁹, N G Papadopoulos^{60

61}, I Annesi-Maesano^{62

63}, M Bewick⁶⁴, S Bosnic-Anticevich^{65

66}, A A Cruz^{67

68}, G De Vries⁷, B Gemicioglu⁶⁹, D Larenas-Linnemann⁷⁰, D Laune⁵, E Mathieu-Dupas⁵, R E O'Hehir^{71

72}, O Pfaar^{38

73}, F Portejoie¹, V Siroux⁷⁴, O Spranger⁷⁵, E Valovirta⁷⁶, O VandenPlas⁷⁷, A Yorgancioglu⁷⁸

Affiliations

¹ Contre les MAladies Chroniques Pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, MACVIA-France, Montpellier, France.
² INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Université Versailles St-Quentin-en-Yvelines, UMR-S168, Villejuif, Montigny le Bretonneux, France.
³ Euforea, Brussels, Belgium.
⁴ Laboratoire de Pharmacologie Respiratoire UPRES EA220, Pôle des Maladies Respiratoires, Hôpital Foch, Suresnes - Université Versailles Saint-Quentin, Versailles, France.
⁵ Kyomed, Montpellier, France.
⁶ EZY, Montpellier, France.
⁷ Peercode BV, Gerdermalsen, The Netherlands.
⁸ Medical Communications Consultant, MedScript Ltd, Dundalk, Ireland.
⁹ Allergy and Respiratory Diseases, Department of Internal Medicine, IRCCS San Martino-IST-University of Genoa, Genoa, Italy.
¹⁰ Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy.
¹¹ Center of Pharmacoeconomics, CIRFF, University of Naples Federico II, Naples, Italy.
¹² Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.
¹³ Servicio de Imunoalergologia, EPE - Nova Medical School, Respiratory Research Group, CEDOC, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
¹⁴ Faculdade de Medicina, Center for Health Technology and Services Research-CINTESIS, Universidade do Porto, Porto, Portugal.
¹⁵ Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal.
¹⁶ Rhinology Unit & Smell Clinic, ENT Department, Hospital Clinic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
¹⁷ Department of Internal Medicine, Center for Health Technology and Services Research-CINTESIS, Centro Hospitalar Sao Joao, Porto, Portugal.
¹⁸ Immunoallergy Department, CUF-Descobertas Hospital, Lisbon, Portugal.
¹⁹ Health Information and Decision Sciences Department, Faculty of Medicine of the University of Porto, Porto, Portugal.
²⁰ Imunoalergologia, Centro Hospitalar Universitario de Coimbra, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
²¹ Allergist, La Rochelle, France.
²² CHU de Montpellier, UPMC, Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Sorbonne Universités, Paris, France.
²³ Allergist, Reims, France.
²⁴ Allergology Department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau - INSERM, UMRS 1136, UPMC Univ Paris 06 - Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Sorbonne Universités, Paris, France.
²⁵ Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Lodz, Poland.
²⁶ HARC, Lodz, Poland.
²⁷ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
²⁸ Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
²⁹ ISGLoBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
³⁰ IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
³¹ CIBER Epidemiologıa y Salud Publica (CIBERESP), Barcelona, Spain.
³² Universitat Pompeu Fabra (UPF), Barcelona, Spain.
³³ Pneumology and Allergy Department Hospital Clınic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
³⁴ Department of ENT, Medical University of Graz, Graz, Austria.
³⁵ Comprehensive Allergy-Centre-Charité, Department of Dermatology and Allergy, Global Allergy and Asthma European Network (GA2LEN), Charité Universitatsmedizin Berlin, Berlin, Germany.
³⁶ Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitatsmedizin, Berlin, Germany.
³⁷ Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany.
³⁸ Center for Rhinology and Allergology, Wiesbaden, Germany.
³⁹ Institute of Medical Statistics and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany.
⁴⁰ CRI-Clinical Research International-Ltd, Hamburg, Germany.
⁴¹ Newcastle OHS, The Newcastle upon Tyne NHS Foundation Hospitals Trust, Newcastle upon Tyne, UK.
⁴² Observational and Pragmatic Research Institute, Singapore City, Singapore.
⁴³ Optimum Patient Care, Cambridge, UK.
⁴⁴ Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK.
⁴⁵ Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
⁴⁶ Asthma UK Centre for Applied Research, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
⁴⁷ Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
⁴⁸ Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
⁴⁹ Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania.
⁵⁰ Vilnius University Clinic of Children's Diseases and Public Health Institute, Vilnius, Lithuania.
⁵¹ European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium.
⁵² ENT Department, Upper Airways Research Laboratory, Ghent University Hospital, Ghent, Belgium.
⁵³ Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
⁵⁴ Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
⁵⁵ Department of Clinical Science and Education, Sodersjukhuset, Karolinska Institutet, Stockholm, Sweden.
⁵⁶ Sodersjukhuset, Sachs' Children and Youth Hospital, Stockholm, Sweden.
⁵⁷ Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
⁵⁸ Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark.
⁵⁹ Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.
⁶⁰ Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.
⁶¹ Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece.
⁶² EPAR U707 INSERM, Paris, France.
⁶³ EPAR UMR-S UPMC, Paris VI, Paris, France.
⁶⁴ i Q4U Consultants Ltd, London, UK.
⁶⁵ Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.
⁶⁶ Sydney Local Health District, Glebe, NSW, Australia.
⁶⁷ ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil.
⁶⁸ GARD Executive Committee, Salvador, Brazil.
⁶⁹ Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
⁷⁰ Center of Excellence in Asthma and Allergy, Hospital Médica Sur, Mexico City, Mexico.
⁷¹ Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia.
⁷² Department of Immunology, Monash University, Melbourne, Vic., Australia.
⁷³ Departent of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannhein, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
⁷⁴ INSERM, Universite Grenoble Alpes, IAB, U 1209, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Université Joseph Fourier, Grenoble, France.
⁷⁵ Global Allergy and Asthma Platform GAAPP, Vienna, Austria.
⁷⁶ Department of Lung Diseases and Clinical Allergology, Terveystalo, Allergy Clinic, University of Turku, Turku, Finland.
⁷⁷ Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium.
⁷⁸ Department of Pulmonology, Celal Bayar University, Manisa, Turkey.

PMID: 29336067
DOI: 10.1111/all.13406

Abstract

Background: Large observational implementation studies are needed to triangulate the findings from randomized control trials as they reflect "real-world" everyday practice. In a pilot study, we attempted to provide additional and complementary insights on the real-life treatment of allergic rhinitis (AR) using mobile technology.

Methods: A mobile phone app (Allergy Diary, freely available in Google Play and Apple App stores) collects the data of daily visual analog scales (VAS) for (i) overall allergic symptoms, (ii) nasal, ocular, and asthma symptoms, (iii) work, as well as (iv) medication use using a treatment scroll list including all medications (prescribed and over the counter (OTC)) for rhinitis customized for 15 countries.

Results: A total of 2871 users filled in 17 091 days of VAS in 2015 and 2016. Medications were reported for 9634 days. The assessment of days appeared to be more informative than the course of the treatment as, in real life, patients do not necessarily use treatment on a daily basis; rather, they appear to increase treatment use with the loss of symptom control. The Allergy Diary allowed differentiation between treatments within or between classes (intranasal corticosteroid use containing medications and oral H1-antihistamines). The control of days differed between no [best control], single, or multiple treatments (worst control).

Conclusions: This study confirms the usefulness of the Allergy Diary in accessing and assessing everyday use and practice in AR. This pilot observational study uses a very simple assessment (VAS) on a mobile phone, shows novel findings, and generates new hypotheses.

Keywords: mHealth; mobile technology; observational study; rhinitis; treatment.

Publication types

Review

MeSH terms

Adult
Combined Modality Therapy
Disease Management
Drug Prescriptions / statistics & numerical data
Female
Global Health
Humans
Male
Medication Adherence
Middle Aged
Mobile Applications*
Pilot Projects
Prospective Studies
Randomized Controlled Trials as Topic
Research Design
Rhinitis, Allergic / epidemiology
Rhinitis, Allergic / prevention & control
Rhinitis, Allergic / therapy*
Young Adult