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2020

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Allergic Rhinitis and Its Impact on Asthma (ARIA) Phase 4 (2018): Change Management in Allergic Rhinitis and Asthma Multimorbidity Using Mobile Technology.

Jean Bousquet 1, Peter W Hellings 2, Ioana Agache 3, Flore Amat 4, Isabella Annesi-Maesano 5, Ignacio J Ansotegui 6, Josep M Anto 7, Claus Bachert 8, Eric D Bateman 9, Anna Bedbrook 10, Kazi Bennoor 11, Mickael Bewick 12, Carsten Bindslev-Jensen 13, Sinthia Bosnic-Anticevich 14, Isabelle Bosse 15, Jan Brozek 16, Luisa Brussino 17, Giorgio W Canonica 18, Victoria Cardona 19, Thomas Casale 20, Alfonso M Cepeda Sarabia 21, Niels H Chavannes 22, Lorenzo Cecchi 23, Jaime Correia de Sousa 24, Elisio Costa 25, Alvaro A Cruz 26, Wienczyslawa Czarlewski 27, Giuseppe De Carlo 28, Giulia De Feo 29, Pascal Demoly 30, Philippe Devillier 31, Mark S Dykewicz 32, Yehia El-Gamal 33, Esben E Eller 13, Joao A Fonseca 34, Jean-François Fontaine 35, Wytske J Fokkens 36, Maria-Antonieta Guzmán 37, Tari Haahtela 38, Maddalena Illario 39, Juan-Carlos Ivancevich 40, Jocelyne Just 4, Igor Kaidashev 41, Musa Khaitov 42, Omer Kalayci 43, Thomas Keil 44, Ludger Klimek 45, Marek L Kowalski 46, Piotr Kuna 47, Violeta Kvedariene 48, Desiree Larenas-Linnemann 49, Daniel Laune 50, Lan T T Le 51, Karin Lodrup Carlsen 52, Olga Lourenço 53, Bassam Mahboub 54, Alpana Mair 55, Enrica Menditto 56, Branislava Milenkovic 57, Mario Morais-Almeida 58, Ralph Mösges 59, Joaquim Mullol 60, Ruth Murray 61, Robert Naclerio 62, Leyla Namazova-Baranova 63, Ettore Novellino 64, Robyn E O'Hehir 65, Ken Ohta 66, Yoshitaka Okamoto 67, Kimi Okubo 68, Gabrielle L Onorato 10, Susanna Palkonen 28, Petr Panzner 69, Nikos G Papadopoulos 70, Hae-Sim Park 71, Ema Paulino 72, Ruby Pawankar 73, Oliver Pfaar 74, Davor Plavec 75, Ted A Popov 76, Paul Potter 77, Emmanuel P Prokopakis 78, Menachem Rottem 79, Dermot Ryan 80, Johanna Salimäki 81, Boleslaw Samolinski 82, Mario Sanchez-Borges 83, Holger J Schunemann 16, Aziz Sheikh 84, Juan-Carlos Sisul 85, Rojin Rajabian-Söderlund 86, Talant Sooronbaev 87, Cristiana Stellato 29, Teresa To 88, Ana-Maria Todo-Bom 89, Peter-Valentin Tomazic 90, Sanna Toppila-Salmi 38, Antonio Valero 91, Arunas Valiulis 92, Erkka Valovirta 93, Maria-Teresa Ventura 94, Martin Wagenmann 95, De Yun Wang 96, Dana Wallace 97, Susan Waserman 98, Magnus Wickman 99, Arzu Yorgancioglu 100, Luo Zhang 101, Nanshan Zhong 102, Mihaela Zidarn 103, Torsten Zuberbier 104, Mobile Airways Sentinel Network (MASK) Study Group

1 - University Hospital, Montpellier, France; MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France; VIMA, INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny-le-Bretonneux, and Euforea, Brussels, Belgium. Electronic address: Este endereço de email está protegido contra piratas. Necessita ativar o JavaScript para o visualizar..
2 - Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
3 - Transylvania University Brasov, Brasov, Romania.
4 - Allergology Department, Centre de l'Asthme et des Allergies Hôpital d'Enfants Armand-Trousseau (APHP), and Sorbonne Université, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France.
5 - Epidemiology of Allergic and Respiratory Diseases Department, Institute Pierre Louis of Epidemiology and Public Health, INSERM, and UPMC Sorbonne Université, Medical School Saint Antoine, Paris, France.
6 - Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain.
7 - ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; IMIM (Hospital del Mar Research Institute), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
8 - Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium.
9 - Department of Medicine, University of Cape Town, Cape Town, South Africa.
10 - MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France.
11 - Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh.
12 - iQ4U Consultants, London, United Kingdom.
13 - Department of Dermatology and Allergy Centre, Odense University Hospital, Odense Research Center for Anaphylaxis (ORCA), Odense, Denmark.
14 - Woolcock Institute of Medical Research, University of Sydney and Woolcock Emphysema Centre and Local Health District, Glebe, Australia.
15 - Allergist in private practice, La Rochelle, France.
16 - Department of Health Research Methods, Evidence, and Impact, Division of Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
17 - Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy.
18 - Personalized Medicine Clinic Asthma & Allergy, Humanitas University, Humanitas Research Hospital, Rozzano, Milan, Italy.
19 - Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, and ARADyAL Spanish Research Network, Barcelona, Spain.
20 - Division of Allergy/Immunology, University of South Florida, Tampa, Fla.
21 - Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, and SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Barranquilla, Colombia.
22 - Department of Public Health and Primary Care, Leiden University Medical Center.
23 - SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
24 - Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, and ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.
25 - UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy Ageing of University of Porto (Porto4Ageing), Porto, Portugal.
26 - ProAR-Nucleo de Excelencia em Asma, Federal University of Bahia, Brasil and WHO GARD Planning Group, Salvador, Brazil.
27 - Medical Consulting Czarlewski, Levallois, France.
28 - European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium.
29 - Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy.
30 - Epidemiology of Allergic and Respiratory Diseases Department, Institute Pierre Louis of Epidemiology and Public Health, INSERM, and UPMC Sorbonne Université, Medical School Saint Antoine, Paris, France; Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France.
31 - Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes, Université Versailles Saint-Quentin, Université Paris Saclay, Paris, France.
32 - Section of Allergy and Immunology, Saint Louis University School of Medicine, St Louis, Mo.
33 - Pediatric Allergy and Immunology Unit, Children's hospital, Ain Shams University, Cairo, Egypt.
34 - CINTESIS, Center for research in health technologies and information systems, Faculdade de Medicina da Universidade do Porto, and MEDIDA, Lda, Porto, Portugal.
35 - Allergist in private practice, Reims, France.
36 - Department of Otorhinolaryngology, Academic Medical Centres, AMC, Amsterdam, The Netherlands.
37 - Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile.
38 - Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
39 - Division for Health Innovation, Campania Region and Federico II University and Hospital Naples (DISMET and R1D Unit) Naples, Naples, Italy.
40 - Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
41 - Ukrainina Medical Stomatological Academy, Poltava, Ukraine.
42 - National Research Center, Institute of Immunology, Federal Medicobiological Agency, Laboratory of Molecular immunology, Moscow, Russian Federation.
43 - Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey.
44 - Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, and the Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany.
45 - Center for Rhinology and Allergology, Wiesbaden, Germany.
46 - Department of Immunology and Allergy, Healthy Ageing Research Center, Medical University of Lodz, Lodz, Poland.
47 - Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
48 - Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
49 - Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
50 - Kyomed, Montpellier, France.
51 - University of Medicine and Pharmacy, Hochiminh City, Vietnam.
52 - Oslo University Hospital, Department of Paediatrics, Oslo, and the University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.
53 - Faculty of Health Sciences and CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
54 - Department of Pulmonary Medicine, Rashid Hospital, Dubai, United Arab Emirates.
55 - DG for Health & Social Care, Scottish Government, Edinburgh, United Kingdom.
56 - CIRFF, Federico II University, Naples, Italy.
57 - Clinic for Pulmonary Diseases, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Serbian Association for Asthma and COPD, Belgrade, Serbia.
58 - Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
59 - Institute of Medical Statistics, and Computational Biology, Medical Faculty, University of Cologne, and CRI-Clinical Research International, Hamburg, Germany.
60 - Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain.
61 - MedScript, Dundalk, Ireland.
62 - Johns Hopkins School of Medicine, Baltimore, Md.
63 - Scientific Centre of Children's Health under the MoH, Moscow, Russian Federation.
64 - Department of Pharmacy of University of Naples Federico II, Naples, Italy.
65 - OHEHIR. Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, and the Department of Immunology, Monash University, Melbourne, Australia.
66 - National Hospital Organization, Tokyo National Hospital, Tokyo, Japan.
67 - Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
68 - Department of Otolaryngology, Nippon Medical School, Tokyo, Japan.
69 - Department of Immunology and Allergology, Faculty of Medicine in Pilsen, Charles University Prague, Prague, Czech Republic.
70 - Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, and the Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece.
71 - Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea.
72 - Farmacias Holon, Lisbon, Portugal.
73 - Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
74 - Center for Rhinology and Allergology, Wiesbaden, Germany; Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
75 - Children's Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia.
76 - University Hospital "Sv Ivan Rilski", Sofia, Bulgaria.
77 - Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
78 - Department of Otorhinolaryngology University of Crete School of Medicine, Heraklion, Greece.
79 - Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel.
80 - Allergy and Respiratory Research Group, University of Edinburgh, Edinburgh, United Kingdom.
81 - Association of Finnish Pharmacies, Helsinki, Finland.
82 - Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland.
83 - Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad and Clínica El Avila, Caracas, Venezuela.
84 - Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom.
85 - Sociedad Paraguaya de Alergia Asma e Inmunologı'a, Asuncion.
86 - Department of Nephrology and Endocrinology, Karolinska University Hospital, Stockholm, Sweden.
87 - Kyrgyzstan National Centre of Cardiology and Internal medicine, Euro-Asian respiratory Society, Bishkek, Kyrgyzstan.
88 - Sidkkids hospitala and Institute of Health Policy, Management and Evaluation, Toronto, Ontario, Canada.
89 - Imunoalergologia, Centro Hospitalar Universitário de Coimbra and Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
90 - Department of ENT, Medical University of Graz, Graz, Austria.
91 - Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, University of Barcelona, Barcelona, Spain.
92 - Vilnius University Institute of Clinical Medicine, Clinic of Children's Diseases, and Institute of Health Sciences, Department of Public Health, Vilnius, Lithuania, and the European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium.
93 - Department of Lung Diseases and Clinical Immunology Allergology, University of Turku and Terveystalo Allergy Clinic, Turku, Finland.
94 - University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy.
95 - Department of Otorhinolaryngology, Universitätsklinikum Düsseldorf, Dusseldorf, Germany.
96 - Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
97 - Nova Southeastern University, Fort Lauderdale, Fla.
98 - Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada.
99 - Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
100 - Department of Pulmonology, Celal Bayar University, Manisa, Turkey.
101 - Department of Otolaryngology-Head and Neck Surgery, Beijing TongRen Hospital and Beijing Institute of Otolaryngology, Beijing, China.
102 - State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
103 - University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
104 - Comprehensive Allergy Center Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, and Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany.

Publicação em versão integral: Journal of Allergy and Clinical Immunology 2019;143(3):864-879. 

Resumo: Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.

Palavras Chave: Allergic Rhinitis and Its Impact on Asthma; Change management; asthma; rhinitis.