Behavioural patterns in allergic rhinitis medication in Europe: A study using MASK-air® real-world data
Sousa-Pinto B. Sá-Sousa A. Vieira R.J. Amaral R. Klimek L. Czarlewski W. Antó J.M. Pfaar O. Bedbrook A. Kvedariene V. Ventura M.T. Ansotegui I.J. Bergmann K.-C. Brussino L. Canonica G.W. Cardona V. Carreiro-Martins P. Casale T. Cecchi L. Chivato T. Chu D.K. Cingi C. Costa E.M. Cruz A.A. De Feo G. Devillier P. Fokkens W.J. Gaga M. Gemicioğlu B. Haahtela T. Ivancevich J.C. Ispayeva Z. Jutel M. Kuna P. Kaidashev I. Kraxner H. Larenas-Linnemann D.E. Laune D. Lipworth B. Louis R. Makris M. Monti R. Morais-Almeida M. Mösges R. Mullol J. Odemyr M. Okamoto Y. Papadopoulos N.G. Patella V. Pham-Thi N. Regateiro F.S. Reitsma S. Rouadi P.W. Samolinski B. Sova M. Todo-Bom A. Taborda-Barata L. Tomazic P.V. Toppila-Salmi S. Sastre J. Tsiligianni I. Valiulis A. Vandenplas O. Wallace D. Waserman S. Yorgancioglu A. Zidarn M. Zuberbier T. Fonseca J.A. Bousquet J.
September 2022John Wiley and Sons Inc
Allergy: European Journal of Allergy and Clinical Immunology
2022#77Issue 92699 - 2711 pp.
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.
allergic rhinitis , Co-medication , MASK-air , visual analogue scale
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MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
CINTESIS – Center for Health Technology and Services Research, University of Porto, Porto, Portugal
RISE – Health Research Network; University of Porto, Porto, Portugal
Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany
Center for Rhinology and Allergology, Wiesbaden, Germany
Medical Consulting Czarlewski, Levallois, France
MASK-air, Montpellier, France
ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
Universitat Pompeu Fabra (UPF), Barcelona, Spain
CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany
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
University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy
Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
Institute of Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
Allergy Section, Department of Internal Medicine, Hospital Vall dHebron & ARADyAL Research Network, Barcelona, Spain
Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
NOVA Medical School/Comprehensive Health Research Center (CHRC), Lisbon, Portugal
Division of Allergy/Immunology, University of South Florida, Tampa, FL, United States
SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy
School of Medicine, University CEU San Pablo, Madrid, Spain
Department of Medicine and Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada
Eskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir, Turkey
UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal
Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Brazil
Department of Medicine, Surgery and Dentistry Scuola Medica Salernitana, University of Salerno, Salerno, Italy
VIM Suresnes, UMR_0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch, Université Paris-Saclay, Suresnes, France
Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location AMC, Amsterdam, Netherlands
ERS President 2017-2018, 7th Resp Med Department and Asthma Center, Athens Chest Hospital, Athens, Greece
Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
Department of Allergology and Clinical Immunology of the Kazakh National Medical University, Almaty, Kazakhstan
Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland
Department of Clinical Immunology, ALL-MED Medical Research Institute, Wrocław, Poland
Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
Poltava State Medical University, Poltava, Ukraine
Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary
Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico
KYomed INNOV, Montpellier, France
Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, United Kingdom
Department of Pulmonary Medicine, CHU Sart-Tilman, and GIGA I3 Research Group, Liege, Belgium
Allergy Unit D Kalogeromitros, 2nd Department of Dermatology and Venereology, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal
IMSB, Medical Faculty, University of Cologne, and ClinCompetence Cologne GmbH, Cologne, Germany
Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
EFA European Federation of Allergy and Airways Diseases Patients’ Associations, Brussels, Belgium
Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
Division of Allergy and Clinical Immunology, Department of Medicine, Agency of Health ASL Salerno, Santa Maria della Speranza Hospital, Battipaglia, Salerno, Italy
Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France
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
Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon, and ENT Department, Dar Al Shifa Hospital, Salmiya, Kuwait
Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
Department of Pulmonary medicine and tuberculosis, University Hospital Brno, Brno, Czech Republic
Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal
UBIAir - Clinical & Experimental Lung Centre, University of Beira Interior, Covilha, Portugal
Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal
Department of General ORL, H&NS, Medical University of Graz, ENT-University Hospital Graz, Graz, Austria
Skin and Allergy Hospital, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain
Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece, and International Primary Care Respiratory Group IPCRG, Aberdeen, United Kingdom
Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania
Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
Nova Southeastern University, Fort Lauderdale, FL, United States
Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
Department of Pulmonology, Celal Bayar University, Manisa, Turkey
University Clinic of Respiratory and Allergic Diseases, Golnick, and University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
University Hospital Montpellier, Montpellier, France
MEDCIDS – Department of Community Medicine
CINTESIS – Center for Health Technology and Services Research
RISE – Health Research Network; University of Porto
Department of Otolaryngology
Center for Rhinology and Allergology
Medical Consulting Czarlewski
MASK-air
ISGlobal
IMIM (Hospital del Mar Medical Research Institute)
Universitat Pompeu Fabra (UPF)
CIBER Epidemiología y Salud Pública (CIBERESP)
Department of Otorhinolaryngology
Institute of Biomedical Sciences
University of Bari Medical School
Department of Allergy and Immunology
Institute of Allergology
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
Department of Medical Sciences
Department of Biomedical Sciences
Personalized Medicine
Allergy Section
Serviço de Imunoalergologia
NOVA Medical School/Comprehensive Health Research Center (CHRC)
Division of Allergy/Immunology
SOS Allergology and Clinical Immunology
School of Medicine
Department of Medicine and Health Research Methods
Eskisehir Osmangazi University
UCIBIO
Fundaçao ProAR
Department of Medicine
VIM Suresnes
Department of Otorhinolaryngology
ERS President 2017-2018
Department of Pulmonary Diseases
Skin and Allergy Hospital
Servicio de Alergia e Immunologia
Department of Allergology and Clinical Immunology of the Kazakh National Medical University
Department of Clinical Immunology
Department of Clinical Immunology
Division of Internal Medicine
Poltava State Medical University
Department of Otorhinolaryngology
Center of Excellence in Asthma and Allergy
KYomed INNOV
Scottish Centre for Respiratory Research
Department of Pulmonary Medicine
Allergy Unit D Kalogeromitros
Department of Medical Sciences
Allergy Center
IMSB
Rhinology Unit & Smell Clinic
EFA European Federation of Allergy and Airways Diseases Patients’ Associations
Department of Otorhinolaryngology
Allergy Department
Division of Allergy and Clinical Immunology
Ecole Polytechnique Palaiseau
Allergy and Clinical Immunology Unit
Department of Otolaryngology-Head and Neck Surgery
Department of Prevention of Environmental Hazards
Department of Pulmonary medicine and tuberculosis
Faculty of Health Sciences
UBIAir - Clinical & Experimental Lung Centre
Department of Immunoallergology
Department of General ORL
Skin and Allergy Hospital
Fundacion Jimenez Diaz
Health Planning Unit
Institute of Clinical Medicine and Institute of Health Sciences
Department of Chest Medicine
Nova Southeastern University
Department of Medicine
Department of Pulmonology
University Clinic of Respiratory and Allergic Diseases
University Hospital Montpellier
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