Adherence to Treatment in Allergic Rhinitis During the Pollen Season in Europe: A MASK-air Study

IF 6.3 2区 医学 Q1 ALLERGY
Bernardo Sousa-Pinto, Elísio M. Costa, Rafael José Vieira, Ludger Klimek, Wienczyslawa Czarlewski, Oliver Pfaar, Anna Bedbrook, Rita Amaral, Luisa Brussino, Violeta Kvedariene, Desiree E. Larenas-Linnemann, Tomohisa Iinuma, Nhân Pham-Thi, Frederico S. Regateiro, Luis Taborda-Barata, Maria Teresa Ventura, Ignacio J. Ansotegui, Karl C. Bergmann, G. Walter Canonica, Victoria Cardona, Lorenzo Cecchi, Ivan Cherrez-Ojeda, Cemal Cingi, Alvaro A. Cruz, Stefano Del Giacco, Philippe Devillier, Wytske J. Fokkens, Bilun Gemicioglu, Tari Haahtela, Juan Carlos Ivancevich, Piotr Kuna, Helga Kraxner, Daniel Laune, Renaud Louis, Michael Makris, Mario Morais-Almeida, Ralph Mösges, Marek Niedoszytko, Nikolaos G. Papadopoulos, Vincenzo Patella, Ana Margarida Pereira, Sietze Reitsma, Karla Robles-Velasco, Philip W. Rouadi, Boleslaw Samolinski, Milan Sova, Sanna K. Toppila-Salmi, Joaquin Sastre, Arunas Valiulis, Arzu Yorgancioglu, Mihaela Zidarn, Torsten Zuberbier, Joao A. Fonseca, Jean Bousquet, the MASK-air think tank
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引用次数: 0

Abstract

Background

Adherence to rhinitis treatment has been insufficiently assessed. We aimed to use data from the MASK-air mHealth app to assess adherence to oral antihistamines (OAH), intra-nasal corticosteroids (INCS) or azelastine-fluticasone in patients with allergic rhinitis.

Methods

We included regular European MASK-air users with self-reported allergic rhinitis and reporting at least 1 day of OAH, INCS or azelastine-fluticasone. We assessed weeks during which patients answered the MASK-air questionnaire on all days. We restricted our analyses to data provided between January and June, to encompass the pollen seasons across the different assessed countries. We analysed symptoms using visual analogue scales (VASs) and the combined symptom-medication score (CSMS), performing stratified analyses by weekly adherence levels. Medication adherence was computed as the proportion of days in which patients reported rhinitis medication use. Sensitivity analyses were performed considering all weeks with at most 1 day of missing data and all months with at most 4 days of missing data.

Results

We assessed 8212 complete weeks (1361 users). Adherence (use of medication > 80% days) to specific drug classes ranged from 31.7% weeks for azelastine-fluticasone to 38.5% weeks for OAH. Similar adherence to rhinitis medication was found in users with or without self-reported asthma, except for INCS (better adherence in asthma patients). VAS and CSMS levels increased from no adherence to full adherence, except for INCS. A higher proportion of days with uncontrolled symptoms was observed in weeks with higher adherence. In full adherence weeks, 41.2% days reported rhinitis co-medication. The sensitivity analyses displayed similar results.

Conclusions

A high adherence was found in patients reporting regular use of MASK-air. Different adherence patterns were found for INCS compared to OAH or azelastine-fluticasone that are likely to impact guidelines.

Abstract Image

欧洲花粉季节变应性鼻炎的治疗依从性:一项面罩-空气研究。
背景:对鼻炎治疗依从性的评估不够充分。我们的目的是使用MASK-air mHealth应用程序的数据来评估变应性鼻炎患者口服抗组胺药(OAH)、鼻内皮质类固醇(INCS)或azelastine-fluticasone的依从性。方法:我们纳入了自我报告过敏性鼻炎并报告至少1天OAH、INCS或azelastine-fluticasone的欧洲面罩-空气常规使用者。我们评估了患者在所有天内回答MASK-air问卷的周数。我们将分析限制在1月至6月之间提供的数据,以涵盖不同评估国家的花粉季节。我们使用视觉模拟量表(VASs)和症状-药物联合评分(CSMS)分析症状,并按每周依从水平进行分层分析。药物依从性计算为患者报告鼻炎药物使用的天数比例。考虑数据缺失最多1天的所有周和数据缺失最多4天的所有月,进行敏感性分析。结果:我们评估了8212个完整周(1361名用户)。对特定药物类别的依从性(使用药物bbb - 80%天)从azelastine-fluticasone的31.7%周到OAH的38.5%周不等。在有或没有自我报告哮喘的使用者中发现类似的鼻炎药物依从性,除了INCS(哮喘患者的依从性更好)。除INCS外,VAS和csm水平从无依从性增加到完全依从性。在依从性较高的周内观察到症状不受控制的天数比例较高。在完全依从周中,41.2%的天数报告了鼻炎联合用药。敏感性分析显示了类似的结果。结论:定期使用MASK-air的患者依从性较高。与OAH或azelastine-fluticasone相比,INCS的不同依从性模式可能会影响指南。
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来源期刊
CiteScore
10.40
自引率
9.80%
发文量
189
审稿时长
3-8 weeks
期刊介绍: Clinical & Experimental Allergy strikes an excellent balance between clinical and scientific articles and carries regular reviews and editorials written by leading authorities in their field. In response to the increasing number of quality submissions, since 1996 the journals size has increased by over 30%. Clinical & Experimental Allergy is essential reading for allergy practitioners and research scientists with an interest in allergic diseases and mechanisms. Truly international in appeal, Clinical & Experimental Allergy publishes clinical and experimental observations in disease in all fields of medicine in which allergic hypersensitivity plays a part.
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