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. 2026 Jan 20;5(3):100647.
doi: 10.1016/j.jacig.2026.100647. eCollection 2026 May.

BRIDGE implementation science study to improve chronic spontaneous urticaria outcomes in Italy

Riccardo Asero  1 , Enrico Iemoli  2 , Nadine Chapman-Rothe  3 , Pallavi Saraswat  4 , Mahrukh Zahid  3 , Ornella Bonavita  5 , Tara Raftery  6 , Piergiacomo Calzavara Pinton  7
Affiliations

BRIDGE implementation science study to improve chronic spontaneous urticaria outcomes in Italy

Riccardo Asero et al. J Allergy Clin Immunol Glob. .

Abstract

Background: Delay in diagnosis and referral to a specialist negatively affects the quality of life of patients with uncontrolled chronic spontaneous urticaria (CSU). The BRIDGE implementation science study is evaluating the effectiveness and feasibility of implementing strategies aiming to improve care for patients with CSU.

Objective: Our aim was to present findings from a contextual analysis of the unmet needs of CSU management in Italy and describe the design of the BRIDGE study, which was developed to address those gaps.

Methods: BRIDGE is a hybrid, effectiveness-implementation science study with a pre-post design involving general practitioners (GPs). A Consolidated Framework for Implementation Research-guided contextual analysis was performed to identify barriers to and facilitators of development and implementation of a strategy aiming to improve care for patients with CSU in Italy.

Results: The barriers to effective management of patients with CSU include lack of awareness of, familiarity with, and knowledge about optimal care for patients with CSU and patient-reported outcomes (PROs), as well as lack of resources for PRO assessment. Additionally, there is an absence of well-established processes and practices for collaboration and effective communication between GPs and CSU specialists. The following implementation strategies were recommended for optimization of CSU care in Italy: (1) targeted training for GPs, guidelines, and utility of PROs to support decision making; (2) development of a guide for GPs to rapidly identify patients with CSU; and (3) improvement of referral networks.

Conclusions: GPs in Italy require additional education and support to improve management of patients with CSU. The BRIDGE study incorporates the aforementioned findings into development and implementation of a tailored educational program, the Urticaria Care Package, to improve care for patients with CSU in Italy.

Keywords: Care pathway; Consolidated Framework for Implementation Research; clinical adoption; implementation science; patient journey; patient referral; patient-reported outcomes; urticaria.

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Conflict of interest statement

Sponsored by Novartis Pharma AG, Basel, Switzerland. Disclosure of potential conflict of interest: R. Asero has received speaker or consultant fees from Novartis, GSK, Sanofi, Jasper Therapeutics, HAL Allergy, and Thermo Fisher Scientific. P. C. Pinton has received consultant fees from Cantabria, Incyte, Sun Pharma, Sanofi, La Roche Posay, Naos, AbbVie, and Boehringer Ingelheim, as well as speaker fees from Novartis, Jannsen, Leo, MSD, and Lilly. N. Chapman-Rothe is an employee of Novartis Pharma AG, Basel, Switzerland, and holds shares of Novartis Pharma AG. P. Saraswat is an employee of Novartis Healthcare Pvt Ltd, Hyderabad, India, and reports holding shares of Novartis Pharma AG. M. Zahid is an employee of Novartis Pharma AG, Basel, Switzerland. O. Bonavita is an employee of Novartis Farma, SpA, Milan, Italy. T. Raftery is an employee of Novartis Ireland, Dublin, Ireland, and reports holding shares of Novartis Pharma AG. The remaining author declares no relevant conflicts of interest.

Figures

Fig 1
Fig 1
BRIDGE Italy: study design and status. HCP, Health care professional.
Fig 2
Fig 2
Contextual analysis results: barriers and strategies to enhance care for patients with CSU in Italy for inclusion in a tailored UCP education package for GPs. HCP, Health care professional.
Supplementary Fig E1
Supplementary Fig E1
Supplementary Fig E2
Supplementary Fig E2
See this image and copyright information in PMC

References

    1. Zuberbier T., Abdul Latiff A.H., Abuzakouk M., Aquilina S., Asero R., Baker D., et al. The international EAACI/GA(2)LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy. 2022;77:734–766. - PubMed
    1. Wagner N., Zink A., Hell K., Reinhardt M., Romer K., Hillmann E., et al. Patients with chronic urticaria remain largely undertreated: results from the DERMLINE online survey. Dermatol Ther. 2021;11:1027–1039. - PMC - PubMed
    1. Maurer M., Abuzakouk M., Berard F., Canonica W., Oude Elberink H., Gimenez-Arnau A., et al. The burden of chronic spontaneus urticaria is substantial: real-world evidence from ASSURE-CSU. Allergy. 2017;72:2005–2016. - PMC - PubMed
    1. Gonçalo M., Gimenéz-Arnau A., Al-Ahmad M., Ben-Shoshan M., Bernstein J.A., Ensina L.F., et al. The global burden of chronic urticaria for the patient and society. Br J Dermatol. 2021;184:226–236. - PubMed
    1. Maurer M., Augustin M., Bauer S., Ekanayake-Bohlig S., Kircher P., Knöll A., et al. Modelling of patient journey in chronic spontaneous urticaria: Increasing awareness and education by shorten patients' disease journey in Germany. J Eur Acad Dermatol Venereol. 2024;38:2093–2101. - PubMed

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