Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases.
Bousquet JJ., Schünemann HJ., Togias A., Erhola M., Hellings PW., Zuberbier T., Agache I., Ansotegui IJ., Anto JM., Bachert C., Becker S., Bedolla-Barajas M., Bewick M., Bosnic-Anticevich S., Bosse I., Boulet LP., Bourrez JM., Brusselle G., Chavannes N., Costa E., Cruz AA., Czarlewski W., Fokkens WJ., Fonseca JA., Gaga M., Haahtela T., Illario M., Klimek L., Kuna P., Kvedariene V., Le LTT., Larenas-Linnemann D., Laune D., Lourenço OM., Menditto E., Mullol J., Okamoto Y., Papadopoulos N., Pham-Thi N., Picard R., Pinnock H., Roche N., Roller-Wirnsberger RE., Rolland C., Samolinski B., Sheikh A., Toppila-Salmi S., Tsiligianni I., Valiulis A., Valovirta E., Vasankari T., Ventura M-T., Walker S., Williams S., Akdis CA., Annesi-Maesano I., Arnavielhe S., Basagana X., Bateman E., Bedbrook A., Bennoor KS., Benveniste S., Bergmann KC., Bialek S., Billo N., Bindslev-Jensen C., Bjermer L., Blain H., Bonini M., Bonniaud P., Bouchard J., Briedis V., Brightling CE., Brozek J., Buhl R., Buonaiuto R., Canonica GW., Cardona V., Carriazo AM., Carr W., Cartier C., Casale T., Cecchi L., Cepeda Sarabia AM., Chkhartishvili E., Chu DK., Cingi C., Colgan E., de Sousa JC., Courbis AL., Custovic A., Cvetkosvki B., D'Amato G., da Silva J., Dantas C., Dokic D., Dauvilliers Y., Dedeu A., De Feo G., Devillier P., Di Capua S., Dykewickz M., Dubakiene R., Ebisawa M., El-Gamal Y., Eller E., Emuzyte R., Farrell J., Fink-Wagner A., Fiocchi A., Fontaine JF., Gemicioğlu B., Schmid-Grendelmeir P., Gamkrelidze A., Garcia-Aymerich J., Gomez M., González Diaz S., Gotua M., Guldemond NA., Guzmán M-A., Hajjam J., O'B Hourihane J., Humbert M., Iaccarino G., Ierodiakonou D., Illario M., Ivancevich JC., Joos G., Jung K-S., Jutel M., Kaidashev I., Kalayci O., Kardas P., Keil T., Khaitov M., Khaltaev N., Kleine-Tebbe J., Kowalski ML., Kritikos V., Kull I., Leonardini L., Lieberman P., Lipworth B., Lodrup Carlsen KC., Loureiro CC., Louis R., Mair A., Marien G., Mahboub B., Malva J., Manning P., De Manuel Keenoy E., Marshall GD., Masjedi MR., Maspero JF., Mathieu-Dupas E., Matricardi PM., Melén E., Melo-Gomes E., Meltzer EO., Menditto E., Mercier J., Miculinic N., Mihaltan F., Milenkovic B., Moda G., Mogica-Martinez M-D., Mohammad Y., Montefort S., Monti R., Morais-Almeida M., Mösges R., Münter L., Muraro A., Murray R., Naclerio R., Napoli L., Namazova-Baranova L., Neffen H., Nekam K., Neou A., Novellino E., Nyembue D., O'Hehir R., Ohta K., Okubo K., Onorato G., Ouedraogo S., Pali-Schöll I., Palkonen S., Panzner P., Park H-S., Pépin J-L., Pereira A-M., Pfaar O., Paulino E., Phillips J., Picard R., Plavec D., Popov TA., Portejoie F., Price D., Prokopakis EP., Pugin B., Raciborski F., Rajabian-Söderlund R., Reitsma S., Rodo X., Romano A., Rosario N., Rottem M., Ryan D., Salimäki J., Sanchez-Borges MM., Sisul J-C., Solé D., Somekh D., Sooronbaev T., Sova M., Spranger O., Stellato C., Stelmach R., Suppli Ulrik C., Thibaudon M., To T., Todo-Bom A., Tomazic PV., Valero AA., Valenta R., Valentin-Rostan M., van der Kleij R., Vandenplas O., Vezzani G., Viart F., Viegi G., Wallace D., Wagenmann M., Wang DY., Waserman S., Wickman M., Williams DM., Wong G., Wroczynski P., Yiallouros PK., Yorgancioglu A., Yusuf OM., Zar HJ., Zeng S., Zernotti M., Zhang L., Zhong NS., Zidarn M., ARIA Study Group None., MASK Study Group None.
BackgroundIn all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.Main bodyAs an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care.ConclusionIn 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.