Behavioural patterns in allergic rhinitis medication in Europe: A study using MASK-air^® real-world data

Bernardo Sousa-Pinto^{1

2

3}, Ana Sá-Sousa^{1

2

3}, Rafael José Vieira^{1

2

3}, Rita Amaral^{1

2

3}, Ludger Klimek^{4

5}, Wienczyslawa Czarlewski^{6

7}, Josep M Antó^{8

9

10

11}, Oliver Pfaar¹², Anna Bedbrook⁷, Violeta Kvedariene¹³, Maria Teresa Ventura¹⁴, Ignacio J Ansotegui¹⁵, Karl-Christian Bergmann^{16

17}, Luisa Brussino¹⁸, G Walter Canonica^{19

20}, Victoria Cardona²¹, Pedro Carreiro-Martins^{22

23}, Tomas Casale²⁴, Lorenzo Cecchi²⁵, Tomás Chivato²⁶, Derek K Chu²⁷, Cemal Cingi²⁸, Elísio M Costa²⁹, Alvaro A Cruz³⁰, Giulia De Feo³¹, Philippe Devillier³², Wytske J Fokkens³³, Mina Gaga³⁴, Bilun Gemicioğlu³⁵, Tari Haahtela³⁶, Juan Carlos Ivancevich³⁷, Zhanat Ispayeva³⁸, Marek Jutel^{39

40}, Piotr Kuna⁴¹, Igor Kaidashev⁴², Helga Kraxner⁴³, Désirée E Larenas-Linnemann⁴⁴, Daniel Laune⁴⁵, Brian Lipworth⁴⁶, Renaud Louis⁴⁷, Michael Makris⁴⁸, Riccardo Monti¹⁸, Mario Morais-Almeida⁴⁹, Ralph Mösges⁵⁰, Joaquim Mullol⁵¹, Mikaëla Odemyr⁵², Yoshitaka Okamoto⁵³, Nikolaos G Papadopoulos⁵⁴, Vincenzo Patella⁵⁵, Nhân Pham-Thi⁵⁶, Frederico S Regateiro⁵⁷, Sietze Reitsma³³, Philip W Rouadi⁵⁸, Boleslaw Samolinski⁵⁹, Milan Sova⁶⁰, Ana Todo-Bom⁵⁸, Luis Taborda-Barata^{61

62

63}, Peter Valentin Tomazic⁶⁴, Sanna Toppila-Salmi⁶⁵, Joaquin Sastre⁶⁶, Ioanna Tsiligianni⁶⁷, Arunas Valiulis⁶⁸, Olivier Vandenplas⁶⁹, Dana Wallace⁷⁰, Susan Waserman⁷¹, Arzu Yorgancioglu⁷², Mihaela Zidarn⁷³, Torsten Zuberbier^{16

17}, João A Fonseca^{1

2

3}, Jean Bousquet^{16

17

74}

Affiliations

¹ MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
² CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal.
³ RISE - Health Research Network; University of Porto, Porto, Portugal.
⁴ Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany.
⁵ Center for Rhinology and Allergology, Wiesbaden, Germany.
⁶ Medical Consulting Czarlewski, Levallois, France.
⁷ MASK-air, Montpellier, France.
⁸ ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.
⁹ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
¹⁰ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
¹¹ CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
¹² Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
¹³ Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University and Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
¹⁴ University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy.
¹⁵ Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain.
¹⁶ Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
¹⁷ Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
¹⁸ Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy.
¹⁹ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
²⁰ Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy.
²¹ Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL Research Network, Barcelona, Spain.
²² Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
²³ NOVA Medical School/Comprehensive Health Research Center (CHRC), Lisbon, Portugal.
²⁴ Division of Allergy/Immunology, University of South Florida, Tampa, Florida, USA.
²⁵ SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
²⁶ School of Medicine, University CEU San Pablo, Madrid, Spain.
²⁷ Department of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.
²⁸ Eskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey.
²⁹ UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal.
³⁰ Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Brazil.
³¹ Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.
³² VIM Suresnes, UMR_0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France.
³³ Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location AMC, Amsterdam, The Netherlands.
³⁴ ERS President 2017-2018, 7th Resp Med Department and Asthma Center, Athens Chest Hospital, Athens, Greece.
³⁵ Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
³⁶ Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
³⁷ Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
³⁸ Department of Allergology and Clinical Immunology of the Kazakh National Medical University, Almaty, Kazakhstan.
³⁹ Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland.
⁴⁰ Department of Clinical Immunology, ALL-MED Medical Research Institute, Wrocław, Poland.
⁴¹ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
⁴² Poltava State Medical University, Poltava, Ukraine.
⁴³ Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary.
⁴⁴ Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
⁴⁵ KYomed INNOV, Montpellier, France.
⁴⁶ Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK.
⁴⁷ Department of Pulmonary Medicine, CHU Sart-Tilman, and GIGA I3 Research Group, Liege, Belgium.
⁴⁸ Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
⁴⁹ Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
⁵⁰ IMSB, Medical Faculty, University of Cologne, and ClinCompetence Cologne GmbH, Cologne, Germany.
⁵¹ Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
⁵² EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium.
⁵³ Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
⁵⁴ Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
⁵⁵ Division of Allergy and Clinical Immunology, Department of Medicine, Agency of Health ASL Salerno, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy.
⁵⁶ Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France.
⁵⁷ Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, and Institute of Immunology, Faculty of Medicine, University of Coimbra, and Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
⁵⁸ Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon, and ENT Department, Dar Al Shifa Hospital, Salmiya, Kuwait.
⁵⁹ Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland.
⁶⁰ Department of Pulmonary medicine and tuberculosis, University Hospital Brno, Brno, Czech Republic.
⁶¹ Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal.
⁶² UBIAir - Clinical & Experimental Lung Centre, University of Beira Interior, Covilha, Portugal.
⁶³ Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal.
⁶⁴ Department of General ORL, H&NS, Medical University of Graz, ENT-University Hospital Graz, Graz, Austria.
⁶⁵ Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.
⁶⁶ Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain.
⁶⁷ Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece, and International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.
⁶⁸ Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania.
⁶⁹ Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium.
⁷⁰ Nova Southeastern University, Fort Lauderdale, Florida, USA.
⁷¹ Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada.
⁷² Department of Pulmonology, Celal Bayar University, Manisa, Turkey.
⁷³ University Clinic of Respiratory and Allergic Diseases, Golnick, and University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia.
⁷⁴ University Hospital Montpellier, Montpellier, France.

PMID: 35258105
DOI: 10.1111/all.15275

Behavioural patterns in allergic rhinitis medication in Europe: A study using MASK-air^® real-world data

Bernardo Sousa-Pinto et al. Allergy. 2022 Sep.

. 2022 Sep;77(9):2699-2711.

doi: 10.1111/all.15275. Epub 2022 Mar 17.

Authors

Affiliations

¹ MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal.
² CINTESIS - Center for Health Technology and Services Research, University of Porto, Porto, Portugal.
³ RISE - Health Research Network; University of Porto, Porto, Portugal.
⁴ Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany.
⁵ Center for Rhinology and Allergology, Wiesbaden, Germany.
⁶ Medical Consulting Czarlewski, Levallois, France.
⁷ MASK-air, Montpellier, France.
⁸ ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.
⁹ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
¹⁰ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
¹¹ CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
¹² Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
¹³ Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University and Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
¹⁴ University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy.
¹⁵ Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain.
¹⁶ Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
¹⁷ Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
¹⁸ Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy.
¹⁹ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
²⁰ Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy.
²¹ Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron & ARADyAL Research Network, Barcelona, Spain.
²² Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.
²³ NOVA Medical School/Comprehensive Health Research Center (CHRC), Lisbon, Portugal.
²⁴ Division of Allergy/Immunology, University of South Florida, Tampa, Florida, USA.
²⁵ SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
²⁶ School of Medicine, University CEU San Pablo, Madrid, Spain.
²⁷ Department of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.
²⁸ Eskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey.
²⁹ UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal.
³⁰ Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Brazil.
³¹ Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.
³² VIM Suresnes, UMR_0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France.
³³ Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location AMC, Amsterdam, The Netherlands.
³⁴ ERS President 2017-2018, 7th Resp Med Department and Asthma Center, Athens Chest Hospital, Athens, Greece.
³⁵ Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
³⁶ Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
³⁷ Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
³⁸ Department of Allergology and Clinical Immunology of the Kazakh National Medical University, Almaty, Kazakhstan.
³⁹ Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland.
⁴⁰ Department of Clinical Immunology, ALL-MED Medical Research Institute, Wrocław, Poland.
⁴¹ Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
⁴² Poltava State Medical University, Poltava, Ukraine.
⁴³ Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary.
⁴⁴ Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
⁴⁵ KYomed INNOV, Montpellier, France.
⁴⁶ Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK.
⁴⁷ Department of Pulmonary Medicine, CHU Sart-Tilman, and GIGA I3 Research Group, Liege, Belgium.
⁴⁸ Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
⁴⁹ Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
⁵⁰ IMSB, Medical Faculty, University of Cologne, and ClinCompetence Cologne GmbH, Cologne, Germany.
⁵¹ Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
⁵² EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium.
⁵³ Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
⁵⁴ Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
⁵⁵ Division of Allergy and Clinical Immunology, Department of Medicine, Agency of Health ASL Salerno, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy.
⁵⁶ Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France.
⁵⁷ Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, and Institute of Immunology, Faculty of Medicine, University of Coimbra, and Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
⁵⁸ Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon, and ENT Department, Dar Al Shifa Hospital, Salmiya, Kuwait.
⁵⁹ Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland.
⁶⁰ Department of Pulmonary medicine and tuberculosis, University Hospital Brno, Brno, Czech Republic.
⁶¹ Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal.
⁶² UBIAir - Clinical & Experimental Lung Centre, University of Beira Interior, Covilha, Portugal.
⁶³ Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal.
⁶⁴ Department of General ORL, H&NS, Medical University of Graz, ENT-University Hospital Graz, Graz, Austria.
⁶⁵ Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland.
⁶⁶ Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain.
⁶⁷ Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece, and International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.
⁶⁸ Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania.
⁶⁹ Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium.
⁷⁰ Nova Southeastern University, Fort Lauderdale, Florida, USA.
⁷¹ Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada.
⁷² Department of Pulmonology, Celal Bayar University, Manisa, Turkey.
⁷³ University Clinic of Respiratory and Allergic Diseases, Golnick, and University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia.
⁷⁴ University Hospital Montpellier, Montpellier, France.

PMID: 35258105
DOI: 10.1111/all.15275

Abstract

Background: Co-medication is common among patients with allergic rhinitis (AR), but its dimension and patterns are unknown. This is particularly relevant since AR is understood differently across European countries, as reflected by rhinitis-related search patterns in Google Trends. This study aims to assess AR co-medication and its regional patterns in Europe, using real-world data.

Methods: We analysed 2015-2020 MASK-air^® European data. We compared days under no medication, monotherapy and co-medication using the visual analogue scale (VAS) levels for overall allergic symptoms ('VAS Global Symptoms') and impact of AR on work. We assessed the monthly use of different medication schemes, performing separate analyses by region (defined geographically or by Google Trends patterns). We estimated the average number of different drugs reported per patient within 1 year.

Results: We analysed 222,024 days (13,122 users), including 63,887 days (28.8%) under monotherapy and 38,315 (17.3%) under co-medication. The median 'VAS Global Symptoms' was 7 for no medication days, 14 for monotherapy and 21 for co-medication (p < .001). Medication use peaked during the spring, with similar patterns across different European regions (defined geographically or by Google Trends). Oral H₁ -antihistamines were the most common medication in single and co-medication. Each patient reported using an annual average of 2.7 drugs, with 80% reporting two or more.

Conclusions: Allergic rhinitis medication patterns are similar across European regions. One third of treatment days involved co-medication. These findings suggest that patients treat themselves according to their symptoms (irrespective of how they understand AR) and that co-medication use is driven by symptom severity.

Keywords: Co-medication; MASK-air; allergic rhinitis; visual analogue scale.

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References

REFERENCES

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Behavioural patterns in allergic rhinitis medication in Europe: A study using MASK-air^® real-world data

Affiliations

Behavioural patterns in allergic rhinitis medication in Europe: A study using MASK-air^® real-world data

Authors

Affiliations

Abstract

References

REFERENCES

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LinkOut - more resources

Full Text Sources

Research Materials