Archives of Hellenic Medicine

Last update:

25-Nov-2018

Arch Hellen Med, 35(6), November-December 2018, 824-833

SPECIAL ARTICLE

Allergic rhinitis and its impact on asthma (ARIA) in Greece:
Integrated care pathways for predictive medicine across the life cycle

N.G. Papadopoulos,¹ M.V. Dimou,^1,2 T. Vontetsianos,³ P. Giallouros,⁴ M. Gaga,⁵ V. Danielidis,⁶ N. Douladiris,¹ M. Makris,⁷ N. Mikos,⁸ P. Marangoudakis,⁹ P. Xepapadaki,¹ V. Papanikolaou,¹⁰ K. Pitsios,⁴ E. Prokopakis,¹¹ N. Siafakas,¹² L. Xantzi,¹³ F. Psarros,¹⁴ X. Aggelidis,⁷ M. Vallianatou,¹ D. Vourdas,¹⁵ C. Grigoreas,¹⁶ M. Doulaptsi,¹⁷ M. Katotomichelakis,¹⁸ T. Kapsali,¹⁹ E. Kompoti,⁸ M. Kyriakakou,¹ S. Loukidis,²⁰ E. Manousakis,¹ P. Mpakakos,²¹ S. Βotskariova,¹ I. Paraskevopoulos,²² K. Piskou,²³ N. Rovina,²¹ S. Stamataki,²⁴ E. Stefanaki,²⁵ E. Syrigou,²⁶ I. Agache,²⁷ C. Bachert,²⁸ A. Bedbrook,²⁹ G.W. Canonica,³⁰ T. Casale,³¹ Cruz,³² W.J. Fokkens,³³ P.W. Hellings,³⁴ B. Samolinski,³⁵ J. Bousquet^29,36
¹Unit of Allergology and Clinical Immunology, Second Department of Pediatrics, "Panagiotis & Aglaia Kiriakou" General Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece,
²Unit of Allergy-Asthma and Inflammation, First Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece,
³eHealth Unit, "Sotiria" Regional Chest Diseases Hospital, Athens, Greece,
⁴Medical School, University of Cyprus, Nicosia, Cyprus,
⁵Asthma Centre, "Sotiria" Regional Chest Diseases Hospital, Athens, Greece,
⁶Department of Otorhinolaryngology (ENT), University Hospital of Patras, Patras, Greece,
⁷"D. Kalogeromitros" Allergy Unit, Second Department of Dermatology and Venereology, "Attikon" General Hospital, National and Kapodistrian University of Athens, Athens, Greece,
⁸Department of Allergology and Clinical Immunology, "Laikon" General Hospital, Athens, Greece,
⁹Second Department of ENT, "Attikon" General Hospital, National and Kapodistrian University of Athens, Athens, Greece,
¹⁰First University Department of ENT, National and Kapodistrian University of Athens, Athens, Greece,
¹¹Department of ENT, University of Crete, Heraklion, Crete, Greece,
¹²Medical School, University of Crete, Heraklion, Crete, Greece,
¹³Department of Epidemiology, University of Crete, Heraklion, Crete, Greece,
¹⁴Department of Allergy, Naval Hospital of Athens, Athens, Greece,
¹⁵Department of Allergy, 251 Hellenic Air Force General Hospital, Athens, Greece,
¹⁶President of the Hellenic Society of Allergology and Clinical Immunology, Athens, Greece,
¹⁷Department of ENT, University Hospital of Heraklion (PAGNI), Heraklion, Crete, Greece,
¹⁸Department of ENT, University Hospital of Alexandroupolis, Medical School, Democritus University of Thrace, Alexandroupolis, Greece,
¹⁹Private Allergist, Athens, Greece,
²⁰Second Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, Greece,
²¹First Department of Respiratory Medicine, National and Kapodistrian University of Athens, Athens, Greece,
²²Department of Allergy, 401 General Military Hospital of Athens, Athens, Greece,
²³"Euroclinic" Children's Hospital, Athens, Greece,
²⁴Department of ENT, "Panagiotis & Aglaia Kiriakou" General Children's Hospital, Athens, Greece,
²⁵Department of Pediatrics, "Venizelio" General Hospital of Heraklion, Heraklion, Crete, Greece,
²⁶Department of Allergy for Children and Adults, "Sotiria" Regional Chest Diseases Hospital, Athens, Greece,
²⁷Transilvania University of Brasov, Brasov, Romania,
²⁸Upper Airways Research Laboratorium, Department of ENT, Ghent University Hospital, Ghent, Belgium,
²⁹MACVIA-France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France,
³⁰Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy,
³¹Division of Allergy/ Immunology, University of South Florida, Tampa, FL, USA,
³²ProAR – Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil; GARD Executive Committee, Salvador, Bahia, Brazil,
³³Department of ENT, Academic Medical Centre, Amsterdam, The Netherlands,
³⁴Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium,
³⁵Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland,
³⁶University Hospital of Montpellier, Montpellier, France

Allergic rhinitis is a serious global health problem which affects approximately 10–20% of the European population. In 1999, during a workshop of WHO, the project Allergic Rhinitis and its Impact on Asthma (ARIA) was developed. Its objective was to propose a new classification of allergic rhinitis according to the severity and the duration of the symptoms, to promote the idea of multimorbidity of allergic rhinitis and asthma, and to create guidelines for global use, with the help of local stakeholders and experts from all the countries involved. The focus of ARIA during recent years has been the use of new technologies for individualized medical care and prevention. The MASK instrument uses smartphone technology to create care pathways for controlling rhinitis, for both multidisciplinary care teams and the patients themselves. Using a mobile app (Allergy Diary), a patient can assess symptoms, control and productivity using a visual analog scale, which is connected with a clinical decision support system. The information is sent to an interoperable tablet where healthcare professionals can be informed about the patient's rhinitis management. As the European population is ageing, the novel approach of ARIA aims to provide active and healthy ageing in order to improve the quality of life of patients with allergic rhinitis. In Greece, ARIA has been implemented since the early 2000s. In 2017 a new ARIA implementation group was established, consisting of a large number of health care professionals from both Greece and Cyprus. The MASK Allergy Diary has been translated into Greek and is currently being used in clinical practice and research protocols with great enthusiasm. In order to rectify the lack of recent studies on the epidemiology of allergic rhinitis in Greece, MASK will be the instrument which, in combination with aerobiological studies, will form the basis for reporting allergic rhinitis activity around the country.

Key words: Allergy, Asthma, Mobile phone technology, Quality of life, Rhinitis.