Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases
Authors:   the ARIA Study Group, Bousquet J. Jean ,   the MASK Study Group, Schünemann Holger J. , Togias Alkis , Erhola Marina , Hellings Peter W. , Zuberbier Torsten , Agache Ioana , Ansotegui Ignacio J. , Anto Josep M. , Bachert Claus , Becker Sven , Bedolla-Barajas Martin , Bewick Michael , Bosnic-Anticevich Sinthia , Bosse Isabelle , Boulet Louis P. , Bourrez Jean Marc , Brusselle Guy , Chavannes Niels , Costa Elisio , Cruz Alvaro A. , Czarlewski Wienczyslawa , Fokkens Wytske J. , Fonseca Joao A. , Gaga Mina , Haahtela Tari , Illario Maddalena , Klimek Ludger , Kuna Piotr , Kvedariene Violeta , Le L. T. T. , Larenas-Linnemann Desiree , Laune Daniel , Lourenço Olga M. , Menditto Enrica , Mullol Joaquin , Okamoto Yashitaka , Papadopoulos Nikos , Pham-Thi Nhân , Picard Robert , Pinnock Hilary , Roche Nicolas , Roller-Wirnsberger Regina E. , Rolland Christine , Samolinski Boleslaw , Sheikh Aziz , Toppila-Salmi Sanna , Tsiligianni Ioanna , Valiulis Arunas , Valovirta Erkka , Vasankari Tuula , Ventura Maria-Teresa , Walker Samantha , Williams Sian , Akdis Cezmi A. , Annesi-Maesano Isabella , Arnavielhe Sylvie , Basagana Xavier , Bateman Eric , Bedbrook Anna , Bennoor K. S. , Benveniste Samuel , Bergmann Karl C. , Bialek Slawomir , Billo Nils , Bindslev-Jensen Carsten , Bjermer Leif , Blain Hubert , Bonini Mateo , Bonniaud Philippe , Bouchard Jacques , Briedis Vitalis , Brightling Christofer E. , Brozek Jan , Buhl Roland , Buonaiuto Roland , Canonica Giorgo W. , Cardona Victoria , Carriazo Ana M. , Carr Warner , Cartier Christine , Casale Thomas , Cecchi Lorenzo , Cepeda Sarabia Alfonso M. , Chkhartishvili Eka , Chu Derek K. , Cingi Cemal , Colgan Elaine , de Sousa Jaime Correia , Courbis Anne Lise , Custovic Adnan , Cvetkosvki Biljana , D’Amato Gennaro , da Silva Jane , Dantas Carina , Dokic Dejand , Dauvilliers Yves , Dedeu Antoni , De Feo Giulia , Devillier Philippe , Di Capua Stefania , Dykewickz Marc , Dubakiene Ruta , Ebisawa Motohiro , El-Gamal Yaya , Eller Esben , Emuzyte Regina , Farrell John , Fink-Wagner Antjie , Fiocchi Alessandro , Fontaine Jean F. , Gemicioğlu Bilun , Schmid-Grendelmeir Peter , Gamkrelidze Amiran , Garcia-Aymerich Judith , Gomez Maximiliano , González Diaz Sandra , Gotua Maia , Guldemond Nick A. , Guzmán Maria-Antonieta , Hajjam Jawad , O’B Hourihane John , Humbert Marc , Iaccarino Guido , Ierodiakonou Despo , Illario Maddalena , Ivancevich Juan C. , Joos Guy , Jung Ki-Suck , Jutel Marek , Kaidashev Igor , Kalayci Omer , Kardas Przemyslaw , Keil Thomas , Khaitov Mussa , Khaltaev Nikolai , Kleine-Tebbe Jorg , Kowalski Marek L. , Kritikos Vicky , Kull Inger , Leonardini Lisa , Lieberman Philip , Lipworth Brian , Lodrup Carlsen Karin C. , Loureiro Claudia C. , Louis Renaud , Mair Alpana , Marien Gert , Mahboub Bassam , Malva Joao , Manning Patrick , De Manuel Keenoy Esteban , Marshall Gailen D. , Masjedi Mohamed R. , Maspero Jorge F. , Mathieu-Dupas Eve , Matricardi Poalo M. , Melén Eric , Melo-Gomes Elisabete , Meltzer Eli O. , Menditto Enrica , Mercier Jacques , Miculinic Neven , Mihaltan Florin , Milenkovic Branislava , Moda Giuliana , Mogica-Martinez Maria-Dolores , Mohammad Yousser , Montefort Steve , Monti Ricardo , Morais-Almeida Mario , Mösges Ralf , Münter Lars , Muraro Antonella , Murray Ruth , Naclerio Robert , Napoli Luigi , Namazova-Baranova Leila , Neffen Hugo , Nekam Kristoff , Neou Angelo , Novellino Enrico , Nyembue Dieudonné , O’Hehir Robin , Ohta Ken , Okubo Kimi , Onorato Gabrielle , Ouedraogo Solange , Pali-Schöll Isabella , Palkonen Susanna , Panzner Peter , Park Hae-Sim , Pépin Jean-Louis , Pereira Ana-Maria , Pfaar Oliver , Paulino Ema , Phillips Jim , Picard Robert , Plavec Davor , Popov Ted A. , Portejoie Fabienne , Price David , Prokopakis Emmanuel P. , Pugin Benoit , Raciborski Filip , Rajabian-Söderlund Rojin , Reitsma Sietze , Rodo Xavier , Romano Antonino , Rosario Nelson , Rottem Menahenm , Ryan Dermot , Salimäki Johanna , Sanchez-Borges Mario M. , Sisul Juan-Carlos , Solé Dirceu , Somekh David , Sooronbaev Talant , Sova Milan , Spranger Otto , Stellato Cristina , Stelmach Rafael , Suppli Ulrik Charlotte , Thibaudon Michel , To Teresa , Todo-Bom Ana , Tomazic Peter V. , Valero Antonio A. , Valenta Rudolph , Valentin-Rostan Marylin , van der Kleij Rianne , Vandenplas Olivier , Vezzani Giorgio , Viart Frédéric , Viegi Giovanni , Wallace Dana , Wagenmann Martin , Wang De Y. , Waserman Susan , Wickman Magnus , Williams Dennis M. , Wong Gary , Wroczynski Piotr , Yiallouros Panayiotis K. , Yorgancioglu Arzu , Yusuf Osman M. , Zar Heahter J. , Zeng Stéphane , Zernotti Mario , Zhang Luo , Zhong Nan S. , Zidarn Mihaela 
Published: September 2019

Background

In 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 body

As 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.

Conclusion

In 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.