Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Enrica Menditto¹, Elisio Costa², Luis Midão², Sinthia Bosnic-Anticevich³, Ettore Novellino⁴, Slawomir Bialek⁵, Vitalis Briedis⁶, Alpana Mair⁷, Rojin Rajabian-Soderlund⁸, Sylvie Arnavielhe⁹, Anna Bedbrook¹⁰, Wienczyslawa Czarlewski¹¹, Isabella Annesi-Maesano¹², Josep M Anto^{13

14

15

16}, Philippe Devillier^{17

18}, Govert De Vries¹⁹, Thomas Keil^{20

21}, Aziz Sheikh²², Valentina Orlando¹, Désirée Larenas-Linnemann²³, Lorenzo Cecchi²⁴, Giulia De Feo²⁵, M Illario²⁶, Cristiana Stellato²⁵, Joao Fonseca^{27

28}, Joao Malva^{29

30}, Mario Morais-Almeida³¹, Ana Maria Pereira^{32

33}, Ana Maria Todo-Bom³⁴, Violeta Kvedariene³⁵, Arunas Valiulis^{36

37}, Karl Christian Bergmann^{38

39}, Ludger Klimek⁴⁰, Ralph Mösges^{41

42}, Oliver Pfaar⁴³, Torsten Zuberbier^{38

39}, Vicky Cardona⁴⁴, Joaquim Mullol^{45

46}, Nikos G Papadopoulos^{47

48}, Emmanuel P Prokopakis⁴⁹, Mike Bewick⁵⁰, Dermot Ryan⁵¹, Regina E Roller-Wirnsberger⁵², Peter Valentin Tomazic⁵³, Alvaro A Cruz^{54

55}, Piotr Kuna⁵⁶, Boleslaw Samolinski⁵⁷, Wytske J Fokkens⁵⁸, Sietze Reitsma⁵⁸, Isabelle Bosse⁵⁹, Jean-François Fontaine⁶⁰, Daniel Laune⁹, Tari Haahtela⁶¹, Sanna Toppila-Salmi⁶¹, Claus Bachert⁶², Peter W Hellings^{63

64

40}, Erik Melén^{65

66}, Magnus Wickman⁶⁷, Carsten Bindslev-Jensen⁶⁸, Esben Eller⁶⁸, Robyn E O'Hehir^{69

70}, Cemal Cingi⁷¹, Bilun Gemicioğlu⁷², Omer Kalayci⁷³, Juan Carlos Ivancevich⁷⁴, Jean Bousquet^{10

40

75

76}; MASK group

Affiliations

¹ CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy.
² UCIBIO, REQUIMTE, Faculty of Pharmacy, and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), University of Porto, Porto, Portugal.
³ Woolcock Institute of Medical Research, University of Sydney Woolcock Emphysema Centre and Sydney Local Health District, Glebe, New South Wales, Australia.
⁴ University of Naples Federico II, Naples, Italy.
⁵ Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with the Division of Laboratory Medicine, Warsaw Medical University, Warsaw, Poland.
⁶ Lithuanian University of Health Sciences, Kaunas, Lithuania.
⁷ DG for Health and Social Care, Scottish Government, Edinburgh, UK.
⁸ Department of Nephrology and Endocrinology, Karolinska University Hospital, Stockholm, Sweden.
⁹ KYomed INNOV, Montpellier, France.
¹⁰ MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France.
¹¹ Medical Consulting Czarlewski, Levallois, France.
¹² Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Université, Medical School Saint Antoine, Paris, France.
¹³ ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
¹⁴ IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
¹⁵ CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
¹⁶ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
¹⁷ Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes, France.
¹⁸ Université Versailles Saint-Quentin, Université Paris Saclay, Paris Saclay, France.
¹⁹ Peercode BV, Geldermalsen, The Netherlands.
²⁰ Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
²¹ Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany.
²² The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
²³ Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
²⁴ SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
²⁵ Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.
²⁶ Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy.
²⁷ CINTESIS, Center for Research in Health Technologies and Information Systems, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
²⁸ MEDIDA, Lda, Porto, Portugal.
²⁹ Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.
³⁰ Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.
³¹ Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
³² Allergy Unit, CUF-Porto Hospital and Institute, Porto, Portugal.
³³ Center for Research in Health Technologies and Information Systems CINTESIS, Universidade do Porto, Porto, Portugal.
³⁴ Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
³⁵ Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
³⁶ Department of Public Health, Clinic of Children's Diseases, and Institute of Health Sciences, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.
³⁷ European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium.
³⁸ Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
³⁹ Department of Dermatology and Allergy, Comprehensive Allergy Center, Berlin Institute of Health, Berlin, Germany.
⁴⁰ Euforea, Brussels, Belgium.
⁴¹ Medical Faculty, Institute of Medical Statistics, and Computational Biology, University of Cologne, Cologne, Germany.
⁴² CRI-Clinical Research International-Ltd, Hamburg, Germany.
⁴³ Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Germany.
⁴⁴ Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, & ARADyAL Spanish Research Network, Barcelona, Spain.
⁴⁵ Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain.
⁴⁶ Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
⁴⁷ Division of Infection, Immunity& Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.
⁴⁸ Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece.
⁴⁹ Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece.
⁵⁰ iQ4U Consultants Ltd, London, UK.
⁵¹ Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK.
⁵² Department of Internal Medicine, Medical University of Graz, Graz, Austria.
⁵³ Department of ENT, Medical University of Graz, Graz, Austria.
⁵⁴ ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil.
⁵⁵ WHO GARD Planning Group, Salvador, Brazil.
⁵⁶ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
⁵⁷ Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
⁵⁸ Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
⁵⁹ Allergist, La Rochelle, France.
⁶⁰ Allergist, Reims, France.
⁶¹ Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
⁶² Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium.
⁶³ Department of Otorhinolaryngology, Univ Hospitals Leuven, Leuven, Belgium.
⁶⁴ Academic Medical Center, Univ of Amsterdam, Amsterdam, The Netherlands.
⁶⁵ Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
⁶⁶ Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
⁶⁷ Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
⁶⁸ Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark.
⁶⁹ Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
⁷⁰ Department of Immunology, Monash University, Melbourne, Victoria, Australia.
⁷¹ ENT Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey.
⁷² Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
⁷³ Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey.
⁷⁴ Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
⁷⁵ INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France.
⁷⁶ Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.

PMID: 30597673
DOI: 10.1111/cea.13333

Free article

Multicenter Study

Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Enrica Menditto et al. Clin Exp Allergy. 2019 Apr.

Free article

. 2019 Apr;49(4):442-460.

doi: 10.1111/cea.13333. Epub 2019 Mar 12.

Authors

Affiliations

¹ CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, Naples, Italy.
² UCIBIO, REQUIMTE, Faculty of Pharmacy, and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), University of Porto, Porto, Portugal.
³ Woolcock Institute of Medical Research, University of Sydney Woolcock Emphysema Centre and Sydney Local Health District, Glebe, New South Wales, Australia.
⁴ University of Naples Federico II, Naples, Italy.
⁵ Department of Biochemistry and Clinical Chemistry, Faculty of Pharmacy with the Division of Laboratory Medicine, Warsaw Medical University, Warsaw, Poland.
⁶ Lithuanian University of Health Sciences, Kaunas, Lithuania.
⁷ DG for Health and Social Care, Scottish Government, Edinburgh, UK.
⁸ Department of Nephrology and Endocrinology, Karolinska University Hospital, Stockholm, Sweden.
⁹ KYomed INNOV, Montpellier, France.
¹⁰ MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France.
¹¹ Medical Consulting Czarlewski, Levallois, France.
¹² Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and Sorbonne Université, Medical School Saint Antoine, Paris, France.
¹³ ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
¹⁴ IMIM (Hospital del Mar Research Institute), Barcelona, Spain.
¹⁵ CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
¹⁶ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
¹⁷ Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes, France.
¹⁸ Université Versailles Saint-Quentin, Université Paris Saclay, Paris Saclay, France.
¹⁹ Peercode BV, Geldermalsen, The Netherlands.
²⁰ Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.
²¹ Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany.
²² The Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
²³ Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
²⁴ SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
²⁵ Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.
²⁶ Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy.
²⁷ CINTESIS, Center for Research in Health Technologies and Information Systems, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
²⁸ MEDIDA, Lda, Porto, Portugal.
²⁹ Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.
³⁰ Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.
³¹ Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
³² Allergy Unit, CUF-Porto Hospital and Institute, Porto, Portugal.
³³ Center for Research in Health Technologies and Information Systems CINTESIS, Universidade do Porto, Porto, Portugal.
³⁴ Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
³⁵ Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
³⁶ Department of Public Health, Clinic of Children's Diseases, and Institute of Health Sciences, Vilnius University Institute of Clinical Medicine, Vilnius, Lithuania.
³⁷ European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium.
³⁸ Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
³⁹ Department of Dermatology and Allergy, Comprehensive Allergy Center, Berlin Institute of Health, Berlin, Germany.
⁴⁰ Euforea, Brussels, Belgium.
⁴¹ Medical Faculty, Institute of Medical Statistics, and Computational Biology, University of Cologne, Cologne, Germany.
⁴² CRI-Clinical Research International-Ltd, Hamburg, Germany.
⁴³ Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität Marburg, Germany.
⁴⁴ Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, & ARADyAL Spanish Research Network, Barcelona, Spain.
⁴⁵ Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain.
⁴⁶ Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
⁴⁷ Division of Infection, Immunity& Respiratory Medicine, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.
⁴⁸ Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece.
⁴⁹ Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece.
⁵⁰ iQ4U Consultants Ltd, London, UK.
⁵¹ Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK.
⁵² Department of Internal Medicine, Medical University of Graz, Graz, Austria.
⁵³ Department of ENT, Medical University of Graz, Graz, Austria.
⁵⁴ ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil.
⁵⁵ WHO GARD Planning Group, Salvador, Brazil.
⁵⁶ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
⁵⁷ Department of Prevention of Envinronmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
⁵⁸ Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands.
⁵⁹ Allergist, La Rochelle, France.
⁶⁰ Allergist, Reims, France.
⁶¹ Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
⁶² Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium.
⁶³ Department of Otorhinolaryngology, Univ Hospitals Leuven, Leuven, Belgium.
⁶⁴ Academic Medical Center, Univ of Amsterdam, Amsterdam, The Netherlands.
⁶⁵ Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
⁶⁶ Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
⁶⁷ Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
⁶⁸ Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark.
⁶⁹ Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
⁷⁰ Department of Immunology, Monash University, Melbourne, Victoria, Australia.
⁷¹ ENT Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey.
⁷² Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
⁷³ Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey.
⁷⁴ Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
⁷⁵ INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France.
⁷⁶ Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France.

PMID: 30597673
DOI: 10.1111/cea.13333

Abstract

Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries.

Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App.

Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach.

Results: A total of 12 143 users were registered. A total of 6 949 users reported at least one VAS data recording. Among them, 1 887 users reported ≥7 VAS data. About 1 195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR ≥70% and PDC ≤1.25), 51 (4.23%) were partly adherent (MPR ≥70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR <70%). Of those, the largest group was non-adherent to medications and the time interval was increased in 442 (36.68%) users.

Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting.

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

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Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Affiliations

Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Authors

Affiliations

Abstract

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical