EQ-5D-5L (EuroQOL, 5 Domains, 5 Levels) is a widely used health-related quality-of-life instrument, comprising 5 domains. However, it is not known how each domain is impacted by rhinitis or asthma ...control.
To assess the association between rhinitis or asthma control and the different EQ-5D-5L domains using data from the MASK-air mHealth app.
In this cross-sectional study, we assessed data from all MASK-air users (2015-2021; 24 countries). For the levels of each EQ-5D-5L domain, we assessed rhinitis and asthma visual analog scales (VASs) and the combined symptom-medication score (CSMS). We built ordinal multivariable models assessing the adjusted association between VAS/CSMS values and the levels of each EQ-5D-5L domain. Finally, we compared EQ-5D-5L data from users with rhinitis and self-reported asthma with data from users with rhinitis alone.
We assessed 5354 days from 3092 users. We observed an association between worse control of rhinitis or asthma (higher VASs and CSMS) and worse EQ-5D-5L levels. In multivariable models, all VASs and the CSMS were associated with higher levels of pain/discomfort and daily activities. For anxiety/depression, the association was mostly observed for rhinitis-related tools (VAS nose, VAS global, and CSMS), although the presence of self-reported asthma was also associated with worse anxiety/depression. Worse mobility ("walking around") was particularly associated with VAS asthma and with the presence of asthma.
A worse rhinitis control and a worse asthma control are associated with higher EQ-5D-5L levels, particularly regarding pain/discomfort and activity impairment. Worse rhinitis control is associated with worse anxiety/depression, and poor asthma control with worse mobility.
Summary Background Mobile technology may help to better understand the adherence to treatment. MASK ‐rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient‐centred ICT system. ...A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries. Objectives To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App. Methods An observational cross‐sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio ( MPR ) and the Proportion of days covered ( PDC ) approach. Results A total of 12 143 users were registered. A total of 6 949 users reported at least one VAS data recording. Among them, 1 887 users reported ≥7 VAS data. About 1 195 subjects were included in the analysis of adherence. One hundred and thirty‐six (11.28%) users were adherent ( MPR ≥70% and PDC ≤1.25), 51 (4.23%) were partly adherent ( MPR ≥70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non‐adherent to medications ( MPR <70%). Of those, the largest group was non‐adherent to medications and the time interval was increased in 442 (36.68%) users. Conclusion and clinical relevance Adherence to treatment is low. The relative efficacy of continuous vs on‐demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication‐taking behaviour in a real‐world setting.
Abstract Background MASK‐air® is an app that supports allergic rhinitis patients in disease control. Users register daily allergy symptoms and their impact on activities using visual analog scales ...(VASs). We aimed to assess the concurrent validity, reliability, and responsiveness of these daily VASs. Methods Daily monitoring VAS data were assessed in MASK‐air® users with allergic rhinitis. Concurrent validity was assessed by correlating daily VAS values with those of the EuroQol‐5 Dimensions (EQ‐5D) VAS, the Control of Allergic Rhinitis and Asthma Test (CARAT) score, and the Work Productivity and Activity Impairment Allergic Specific (WPAI‐AS) Questionnaire (work and activity impairment scores). Intra‐rater reliability was assessed in users providing multiple daily VASs within the same day. Test–retest reliability was tested in clinically stable users, as defined by the EQ‐5D VAS, CARAT, or “VAS Work” (i.e., VAS assessing the impact of allergy on work). Responsiveness was determined in users with two consecutive measurements of EQ‐5D‐VAS or “VAS Work” indicating clinical change. Results A total of 17,780 MASK‐air® users, with 317,176 VAS days, were assessed. Concurrent validity was moderate–high (Spearman correlation coefficient range: 0.437–0.716). Intra‐rater reliability intraclass correlation coefficients (ICCs) ranged between 0.870 (VAS assessing global allergy symptoms) and 0.937 (VAS assessing allergy symptoms on sleep). Test–retest reliability ICCs ranged between 0.604 and 0.878—“VAS Work” and “VAS asthma” presented the highest ICCs. Moderate/large responsiveness effect sizes were observed—the sleep VAS was associated with lower responsiveness, while the global allergy symptoms VAS demonstrated higher responsiveness. Conclusion In MASK‐air®, daily monitoring VASs have high intra‐rater reliability and moderate–high validity, reliability, and responsiveness, pointing to a reliable measure of symptom loads.
A study was performed to assess the time between drug intake and drug induced hypersensitivity reaction for patients sensitive to nonsteroidal antiinflammatory drugs (NSAID) in clinical patient ...history and after oral provocation tests. Drug hypersensitivity ENDA questionnaires were filled for the patients with suspected sensitivity to NSAID. Oral provocation tests were performed with suspected NSAID according to the ENDA/EAACI recommendations. There were 76 patients with history of hypersensitivity reactions after use of NSAID enrolled in the study. Recorded were 154 hypersensitivity reactions to NSAID in the clinical history. In the clinical history median time of immediate reactions (76 cases, 81%) between drug intake and bronchospasm was 20 minutes 15-30 minutes. Median time of nonimmediate reactions (18 cases, 19%) was 120 minutes 120-390 minutes. There were 50 oral provocation tests performed, 14 of them (28%) were positive. Median time between drug intake and immediate reactions (8; 57% of cases) was 22.5 minutes 20-30 minutes and median time of nonimmediate reactions (6; 43% of cases) was 167.5 minutes 125-206.25 minutes. Time delay between drug intake and bronchospasm in the clinical history and after oral provocation test was not statistically different.
In the literature, generalized reactions after β-lactam skin testing are rare, from 0.1% to 2% of all tested patients and from 0.7% to 9.4% of positive skin-tested patients.6-8 Our 13 patients with ...systemic reaction represent 1.3% of all tested patients and 8.8% of patients with positive skin test result. ...the frequency of generalized reactions is comparable to other published data. Age Sex Type of reaction in clinical history Chronology in clinical history Reactive ST concentration Positive ST Type of reaction after ST Delay after ST 51 M A shock <1 h Prick (1/1) PPL, Cftr Anaphylaxis <30 min 54 F Anaphylaxis <1 h ID (1/10) Amp, MDM, PPL, PG A shock <1 h 38 M A shock <1 h Prick (1/1) Amx, Amp Anaphylaxis <30 min 58 F Anaphylaxis <1 h Prick (1/10) Amx, Amp, MDM, PPL, PG, Cftr, Cftm, Cfrd, Cfur, Cfalo A shock <15 min 46 F A shock <1 h ID (1/10) Amx, Amp, Amx+clav, PG A shock <1 h 41 F Urticaria NA ID (1/1) Amx, Amp G urticaria 14 h 58 F Urticaria 12 h ID (1/1) PPL G urticaria <1.5 h 34 F Anaphylaxis <1 h ID (1/1) Amx Anaphylaxis <1.5 h 47 M A shock <1 h Prick (1/10) Amx, MDM, PG Anaphylaxis <15 min 32 F Anaphylaxis <1 h ID (1/1) Amx, PPL, MDM A shock <1.5 h 21 F Anaphylaxis <1 h ID (1/10) Amx, Amp, PPL, MDM, PG, Cftr Anaphylaxis <1 h 45 M Anaphylaxis <1 h ID (1/1) Amx Anaphylaxis <1.5 h 25 F Macular eruption NA Prick (1/1) Amx, Amp, PPL, PG G urticaria <30 min Table I Description of the patients with generalized reactions during positive skin testslow * Amx, Amoxicillin; Amp, ampicillin; A shock, anaphylactic shock; Cfalo, cefalotine; Cfrd, cefradine; Cftm, cefotaxime; Cftr, ceftriaxone; Cfur, cefuroxime; G urticaria, generalized urticaria; ID, intradermal test; MDM, minor determinant mixture; NA, not available; PG, penicillin G; PPL, penicilloyl polylysine; ST, skin tests.
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