Mobile technology offers novel insights into the control and treatment of allergic rhinitis: The MASK study

Annabelle Bédard¹, Xavier Basagaña¹, Josep M Anto¹, Judith Garcia-Aymerich¹, Philippe Devillier², Sylvie Arnavielhe³, Anna Bedbrook⁴, Gabrielle L Onorato⁴, Wienczyslawa Czarlewski⁵, Ruth Murray⁶, Rute Almeida⁷, Joao Fonseca⁷, Elisio Costa⁸, Joao Malva⁹, Mario Morais-Almeida¹⁰, Ana Margarida Pereira¹¹, Ana Todo-Bom¹², Enrica Menditto¹³, Cristiana Stellato¹⁴, Maria Teresa Ventura¹⁵, Alvaro A Cruz¹⁶, Rafaël Stelmach¹⁷, Jane da Silva¹⁸, Désirée Larenas-Linnemann¹⁹, José M Fuentes-Pérez²⁰, Yunuen R Huerta-Villalobos²⁰, Regina Emuzyte²¹, Violeta Kvedariene²², Arunas Valiulis²³, Piotr Kuna²⁴, Boleslaw Samolinski²⁵, Ludger Klimek²⁶, Ralph Mösges²⁷, Oliver Pfaar²⁸, Sara Shamai²⁷, Isabelle Annesi-Maesano²⁹, Isabelle Bosse³⁰, Pascal Demoly³¹, Jean-François Fontaine³², Vicky Cardona³³, Joaquim Mullol³⁴, Antonio Valero³⁵, Regina E Roller-Wirnsberger³⁶, Peter Valentin Tomazic³⁷, Niels H Chavannes³⁸, Wytske J Fokkens³⁹, Sietze Reitsma³⁹, Mike Bewick⁴⁰, Dermot Ryan⁴¹, Aziz Sheikh⁴², Tari Haahtela⁴³, Sanna Toppila-Salmi⁴³, Erkka Valovirta⁴⁴, Michael Makris⁴⁵, Nikos G Papadopoulos⁴⁶, Emmanuel P Prokopakis⁴⁷, Fotis Psarros⁴⁸, Cemal Cingi⁴⁹, Bilun Gemicioğlu⁵⁰, Arzu Yorgancioglu⁵¹, Sinthia Bosnic-Anticevich⁵², Robyn E O'Hehir⁵³, Claus Bachert⁵⁴, Peter W Hellings⁵⁵, Benoit Pugin⁵⁶, Carsten Bindslev-Jensen⁵⁷, Esben Eller⁵⁷, Ingrid Kull⁵⁸, Erik Melén⁵⁹, Magnus Wickman⁶⁰, Gert De Vries⁶¹, Michiel van Eerd⁶¹, Ioana Agache⁶², Ignacio J Ansotegui⁶³, Mark S Dykewicz⁶⁴, Thomas Casale⁶⁵, Dana Wallace⁶⁶, Susan Waserman⁶⁷, Daniel Laune³, Jean Bousquet⁶⁸; MASK study group

Affiliations

¹ ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
² UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France.
³ KYomed INNOV, Montpellier, France.
⁴ MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France.
⁵ Medical Consulting Czarlewski, Levallois, France.
⁶ Medical Communications Consultant, MedScript, Dundalk, and OPC, Cambridge, United Kingdom.
⁷ Center for Health Technology and Services Research-CINTESIS, Faculdade de Medicina, Universidade do Porto, and Medida, Porto, Portugal.
⁸ UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal.
⁹ Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, and the Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.
¹⁰ Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
¹¹ Allergy Unit, CUF-Porto Hospital and Institute, and the Center for Research in Health Technologies and information systems CINTESIS, Universidade do Porto, Porto, Portugal.
¹² Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
¹³ CIRFF, Federico II University, Naples, Italy.
¹⁴ Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.
¹⁵ Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy.
¹⁶ ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, and the WHO GARD Planning Group, Brazil.
¹⁷ Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.
¹⁸ Department of Internal Medicine and Allergy Clinic of Professor Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.
¹⁹ Center of Excellence in Asthma and Allergy, Hospital Médica Sur, México City, Mexico.
²⁰ Hospital General Region 1, Dr Carlos Mc Gregor Sanchez Navarro" IMSS, Mexico City, Mexico.
²¹ Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
²² Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
²³ Vilnius University Institute of Clinical Medicine, Clinic of Children's Diseases, and the Institute of Health Sciences, Department of Public Health, Vilnius, Lithuania; European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium.
²⁴ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
²⁵ Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
²⁶ Center for Rhinology and Allergology, Wiesbaden, Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
²⁷ Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, and CRI-Clinical Research International, Hamburg, Germany.
²⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Section for Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität, Marburg, Germany.
²⁹ Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and UPMC Sorbonne Université, Medical School Saint Antoine, Paris, France.
³⁰ Allergist, La Rochelle, France.
³¹ Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France.
³² Allergist, Reims, France.
³³ Allergy Section, Department of Internal Medicine, Hospital Vall'dHebron & ARADyAL Research Network, Barcelona, Spain.
³⁴ Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
³⁵ Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain.
³⁶ Department of Internal Medicine, Medical University of Graz, Graz, Austria.
³⁷ Department of ENT, Medical University of Graz, Graz, Austria.
³⁸ Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
³⁹ Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands.
⁴⁰ iQ4U Consultants, London, United Kingdom.
⁴¹ Allergy and Respiratory Research Group, University of Edinburgh, Edinburgh, United Kingdom.
⁴² Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom.
⁴³ Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.
⁴⁴ Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo allergy clinic, Turku, Finland.
⁴⁵ Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
⁴⁶ Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, and UK Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece.
⁴⁷ Department of Otorhinolaryngology University of Crete School of Medicine, Heraklion, Greece.
⁴⁸ Allergy Department, Athens Naval Hospital, Athens, Greece.
⁴⁹ Eskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey.
⁵⁰ Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
⁵¹ Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa (and the GARD Executive Committee), Manisa, Turkey.
⁵² Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; Woolcock Emphysema Centre and Local Health District, Glebe, Australia.
⁵³ Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, and the Department of Immunology, Monash University, Melbourne, Australia.
⁵⁴ Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium.
⁵⁵ Department of Otorhinolaryngology, University Hospitals Leuven, and the Academic Medical Center, University of Amsterdam, and Euforea, Brussels, Belgium.
⁵⁶ European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium.
⁵⁷ Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark.
⁵⁸ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, and Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
⁵⁹ Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
⁶⁰ Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
⁶¹ Peercode BV, Geldermalsen, the Netherlands.
⁶² Transylvania University Brasov, Brasov, Romania.
⁶³ Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain.
⁶⁴ Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, Mo.
⁶⁵ Division of Allergy/Immunology, University of South Florida, Tampa, Fla.
⁶⁶ Nova Southeastern University, Fort Lauderdale, Fla.
⁶⁷ Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada.
⁶⁸ MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France; University Hospital, Montpellier, France; INSERM U 1168, VIMA: Ageing and chronic diseases Epidemiological and Public Health Approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, and Euforea, Brussels, Belgium. Electronic address: jean.bousquet@orange.f.

PMID: 30951790
DOI: 10.1016/j.jaci.2019.01.053

Free article

Observational Study

Mobile technology offers novel insights into the control and treatment of allergic rhinitis: The MASK study

Annabelle Bédard et al. J Allergy Clin Immunol. 2019 Jul.

Free article

. 2019 Jul;144(1):135-143.e6.

doi: 10.1016/j.jaci.2019.01.053. Epub 2019 Apr 3.

Authors

Affiliations

¹ ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
² UPRES EA220, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France.
³ KYomed INNOV, Montpellier, France.
⁴ MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France.
⁵ Medical Consulting Czarlewski, Levallois, France.
⁶ Medical Communications Consultant, MedScript, Dundalk, and OPC, Cambridge, United Kingdom.
⁷ Center for Health Technology and Services Research-CINTESIS, Faculdade de Medicina, Universidade do Porto, and Medida, Porto, Portugal.
⁸ UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal.
⁹ Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, and the Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal.
¹⁰ Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
¹¹ Allergy Unit, CUF-Porto Hospital and Institute, and the Center for Research in Health Technologies and information systems CINTESIS, Universidade do Porto, Porto, Portugal.
¹² Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
¹³ CIRFF, Federico II University, Naples, Italy.
¹⁴ Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.
¹⁵ Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy.
¹⁶ ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, and the WHO GARD Planning Group, Brazil.
¹⁷ Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil.
¹⁸ Department of Internal Medicine and Allergy Clinic of Professor Polydoro Ernani de São Thiago University Hospital, Federal University of Santa Catarina (UFSC), Florianopolis, Brazil.
¹⁹ Center of Excellence in Asthma and Allergy, Hospital Médica Sur, México City, Mexico.
²⁰ Hospital General Region 1, Dr Carlos Mc Gregor Sanchez Navarro" IMSS, Mexico City, Mexico.
²¹ Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
²² Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
²³ Vilnius University Institute of Clinical Medicine, Clinic of Children's Diseases, and the Institute of Health Sciences, Department of Public Health, Vilnius, Lithuania; European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium.
²⁴ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
²⁵ Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
²⁶ Center for Rhinology and Allergology, Wiesbaden, Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
²⁷ Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, and CRI-Clinical Research International, Hamburg, Germany.
²⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Section for Rhinology and Allergy, University Hospital Marburg, Phillipps-Universität, Marburg, Germany.
²⁹ Epidemiology of Allergic and Respiratory Diseases, Department Institute Pierre Louis of Epidemiology and Public Health, INSERM and UPMC Sorbonne Université, Medical School Saint Antoine, Paris, France.
³⁰ Allergist, La Rochelle, France.
³¹ Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France.
³² Allergist, Reims, France.
³³ Allergy Section, Department of Internal Medicine, Hospital Vall'dHebron & ARADyAL Research Network, Barcelona, Spain.
³⁴ Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
³⁵ Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain.
³⁶ Department of Internal Medicine, Medical University of Graz, Graz, Austria.
³⁷ Department of ENT, Medical University of Graz, Graz, Austria.
³⁸ Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
³⁹ Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands.
⁴⁰ iQ4U Consultants, London, United Kingdom.
⁴¹ Allergy and Respiratory Research Group, University of Edinburgh, Edinburgh, United Kingdom.
⁴² Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom.
⁴³ Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.
⁴⁴ Department of Lung Diseases and Clinical Immunology, University of Turku and Terveystalo allergy clinic, Turku, Finland.
⁴⁵ Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
⁴⁶ Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, and UK Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece.
⁴⁷ Department of Otorhinolaryngology University of Crete School of Medicine, Heraklion, Greece.
⁴⁸ Allergy Department, Athens Naval Hospital, Athens, Greece.
⁴⁹ Eskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey.
⁵⁰ Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
⁵¹ Department of Pulmonary Diseases, Celal Bayar University, Faculty of Medicine, Manisa (and the GARD Executive Committee), Manisa, Turkey.
⁵² Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; Woolcock Emphysema Centre and Local Health District, Glebe, Australia.
⁵³ Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, and the Department of Immunology, Monash University, Melbourne, Australia.
⁵⁴ Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium.
⁵⁵ Department of Otorhinolaryngology, University Hospitals Leuven, and the Academic Medical Center, University of Amsterdam, and Euforea, Brussels, Belgium.
⁵⁶ European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium.
⁵⁷ Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark.
⁵⁸ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, and Sach's Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
⁵⁹ Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
⁶⁰ Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
⁶¹ Peercode BV, Geldermalsen, the Netherlands.
⁶² Transylvania University Brasov, Brasov, Romania.
⁶³ Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain.
⁶⁴ Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, Mo.
⁶⁵ Division of Allergy/Immunology, University of South Florida, Tampa, Fla.
⁶⁶ Nova Southeastern University, Fort Lauderdale, Fla.
⁶⁷ Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada.
⁶⁸ MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France; University Hospital, Montpellier, France; INSERM U 1168, VIMA: Ageing and chronic diseases Epidemiological and Public Health Approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, and Euforea, Brussels, Belgium. Electronic address: jean.bousquet@orange.f.

PMID: 30951790
DOI: 10.1016/j.jaci.2019.01.053

Abstract

Background: Mobile health can be used to generate innovative insights into optimizing treatment to improve allergic rhinitis (AR) control.

Objectives: A cross-sectional real-world observational study was undertaken in 22 countries to complement a pilot study and provide novel information on medication use, disease control, and work productivity in the everyday life of patients with AR.

Methods: A mobile phone app (Allergy Diary, which is freely available on Google Play and Apple stores) was used to collect the data of daily visual analogue scale (VAS) scores for (1) overall allergic symptoms; (2) nasal, ocular, and asthma symptoms; (3) work; and (4) medication use by using a treatment scroll list including all allergy medications (prescribed and over-the-counter) customized for 22 countries. The 4 most common intranasal medications containing intranasal corticosteroids and 8 oral H₁-antihistamines were studied.

Results: Nine thousand one hundred twenty-two users filled in 112,054 days of VASs in 2016 and 2017. Assessment of days was informative. Control of days with rhinitis differed between no (best control), single (good control for intranasal corticosteroid-treated days), or multiple (worst control) treatments. Users with the worst control increased the range of treatments being used. The same trend was found for asthma, eye symptoms, and work productivity. Differences between oral H₁-antihistamines were found.

Conclusions: This study confirms the usefulness of the Allergy Diary in accessing and assessing behavior in patients with AR. This observational study using a very simple assessment tool (VAS) on a mobile phone had the potential to answer questions previously thought infeasible.

Keywords: Allergic rhinitis; MASK; antihistamines; asthma; conjunctivitis; corticosteroids; mobile health; treatment.

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Mobile technology offers novel insights into the control and treatment of allergic rhinitis: The MASK study

Affiliations

Mobile technology offers novel insights into the control and treatment of allergic rhinitis: The MASK study

Authors

Affiliations

Abstract

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Research Materials