Abstract
AbstractBackgroundThe number of patients affected by allergies is increasing worldwide. The resulting allergic diseases are leading to significant costs for health care and social systems. Integrated care pathways are needed to enable comprehensive care within the national health systems. The ARIA (Allergic Rhinitis and its Impact on Asthma) initiative develops internationally applicable guidelines for allergic respiratory diseases.MethodsARIA serves to improve the care of patients with allergies and chronic respiratory diseases. In collaboration with other international initiatives, national associations and patient organizations in the field of allergies and respiratory diseases, real-life integrated care pathways have been developed for a digitally assisted, integrative, individualized treatment of allergic rhinitis (AR) with comorbid asthma. In the present work, these integrated care pathways have been adapted to the German situation and health system.ResultsThe present ICP (integrated care pathways) guideline covers key areas of the care of AR patients with and without asthma. It includes the views of patients and other healthcare providers.DiscussionA comprehensive ICP guideline can reflect real-life care better than traditional guideline models.
Highlights
Worldwide, both the number of patients affected by allergies and the costs of allergic diseases are increasing rapidly
This affects beclometasone, fluticasone and mometasone with their esters under the following conditions: The medication may only be given by a doctor after the first diagnosis of seasonal allergic rhinitis A maximum daily dose of 400/200 μg must be maintained Containers and outer shells must provide appropriate information The medicines may only be given to adults the entire treatment chain beginning at the anamnesis, to allergen avoidance, pharmacological therapy, indication and implementation of allergen-specific immunotherapy (AIT) can be performed by an allergological competent specialist or a physician with additional training in allergology, which enables an early AIT
In particular: The efficacy of combined oral H1-antihistamines and intranasal corticosteroids (INCSs) was not found to be more effective than INCSs alone, The efficacy of combined nasal H1-antihistamines and INCSs was found more effective than INCSs alone, Intranasal H1-antihistamines are effective within minutes, Higher costs of a fixed combination of INCSs and nasal H1-antihistamines are justified if the symptoms cannot be controlled otherwise [3]
Summary
The present ICP (integrated care pathways) guideline covers key areas of the care of AR patients with and without asthma. German Institute for Medical Documentation and Information (Deutsches Institut für Medizinische Dokumentation und Information) Daily Treatment Cost European Academy for Allergy and Clinical Immunology European Innovation Partnership on Active and Healthy Ageing European Institute for Innovation and Technology European Medicines Agency European Union Fluticasone Propionate Global Initiative for Asthma General Practitioner Grading of Recommendations-Assessment, Development and Evaluation House Dust Mite Integrated care pathway Intranasal Antihistamine Intranasal Corticosteroid Joint Federal Committee Leukotriene Receptor Antagonist MAladies Chroniques pour un VIeillissement Actif (Fighting chronic diseases for active and healthy ageing) Mobile Airways Sentinel Network (formerly Allergy Diary) Nasal fixed combination combining Azelastine und Fluticasone Mutual Recognition Procedure Member State Named Patients Product Oral Antihistamine Over the Counter Proportion of Days Covered Paul-Ehrlich-Institut Impact of Air POLLution on Asthma and Rhinitis Randomized controlled trial Robert-Koch-Institute Reference Member State Real-world evidence Subcutaneous Immunotherapy Shared Decision Making Social Security Statute Book (Sozialgesetzbuch) Statutory Health Insurance Sublingual Immunotherapy Therapeutic Allergen Order (Therapieallergeneverordnung) United States Visual Analog Scale
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