Adherence to Treatment in Allergic Rhinitis During the Pollen Season in Europe: A MASK-air Study

Bernardo Sousa-Pinto, Elísio M. Costa, Rafael José Vieira, Ludger Klimek, Wienczyslawa Czarlewski, Oliver Pfaar, Anna Bedbrook, Rita Amaral, Luisa Brussino, Violeta Kvedariene, Desiree E. Larenas-Linnemann, Tomohisa Iinuma, Nhân Pham-Thi, Frederico S. Regateiro, Luis Taborda-Barata, Maria Teresa Ventura, Ignacio J. Ansotegui, Karl C. Bergmann, G. Walter Canonica, Victoria CardonaLorenzo Cecchi, Ivan Cherrez-Ojeda, Cemal Cingi, Alvaro A. Cruz, Stefano Del Giacco, Philippe Devillier, Wytske J. Fokkens, Bilun Gemicioglu, Tari Haahtela, Juan Carlos Ivancevich, Piotr Kuna, Helga Kraxner, Daniel Laune, Renaud Louis, Michael Makris, Mario Morais-Almeida, Ralph Mösges, Marek Niedoszytko, Nikolaos G. Papadopoulos, Vincenzo Patella, Ana Margarida Pereira, Sietze Reitsma, Karla Robles-Velasco, Philip W. Rouadi, Boleslaw Samolinski, Milan Sova, Sanna K. Toppila-Salmi, Joaquin Sastre, Arunas Valiulis, Markus Ollert, the MASK-air think tank, jean bousquet*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Background: Adherence to rhinitis treatment has been insufficiently assessed. We aimed to use data from the MASK-air mHealth app to assess adherence to oral antihistamines (OAH), intra-nasal corticosteroids (INCS) or azelastine-fluticasone in patients with allergic rhinitis. Methods: We included regular European MASK-air users with self-reported allergic rhinitis and reporting at least 1 day of OAH, INCS or azelastine-fluticasone. We assessed weeks during which patients answered the MASK-air questionnaire on all days. We restricted our analyses to data provided between January and June, to encompass the pollen seasons across the different assessed countries. We analysed symptoms using visual analogue scales (VASs) and the combined symptom-medication score (CSMS), performing stratified analyses by weekly adherence levels. Medication adherence was computed as the proportion of days in which patients reported rhinitis medication use. Sensitivity analyses were performed considering all weeks with at most 1 day of missing data and all months with at most 4 days of missing data. Results: We assessed 8212 complete weeks (1361 users). Adherence (use of medication > 80% days) to specific drug classes ranged from 31.7% weeks for azelastine-fluticasone to 38.5% weeks for OAH. Similar adherence to rhinitis medication was found in users with or without self-reported asthma, except for INCS (better adherence in asthma patients). VAS and CSMS levels increased from no adherence to full adherence, except for INCS. A higher proportion of days with uncontrolled symptoms was observed in weeks with higher adherence. In full adherence weeks, 41.2% days reported rhinitis co-medication. The sensitivity analyses displayed similar results. Conclusions: A high adherence was found in patients reporting regular use of MASK-air. Different adherence patterns were found for INCS compared to OAH or azelastine-fluticasone that are likely to impact guidelines.

Original languageEnglish
Pages (from-to)226-238
Number of pages13
JournalClinical and Experimental Allergy
Volume55
Issue number3
DOIs
Publication statusPublished - Mar 2025

Keywords

  • Adrenal Cortex Hormones/therapeutic use
  • Adult
  • Anti-Allergic Agents/therapeutic use
  • Europe
  • Female
  • Fluticasone/therapeutic use
  • Histamine Antagonists/therapeutic use
  • Humans
  • Male
  • Medication Adherence
  • Middle Aged
  • Phthalazines/therapeutic use
  • Pollen/immunology
  • Rhinitis, Allergic, Seasonal/drug therapy
  • Seasons
  • Surveys and Questionnaires

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