ARIA pharmacy 2018 “Allergic rhinitis care pathways for community pharmacy”: AIRWAYS ICPs initiative (European Innovation Partnership on Active and Healthy Ageing, DG CONNECT and DG Santé) POLLAR (Impact of Air POLLution on Asthma and Rhinitis) GARD Demonstration project

Pharmacists are trusted health professionals. Many patients use over-the-counter (OTC) medications and are seen by pharmacists who are the initial point of contact of allergic rhinitis management in most countries. The role of pharmacists in integrated care pathways (ICPs) for allergic diseases is important. This paper builds on existing studies and provides tools intended to help pharmacists provide optimal advice/interventions/strategies to patients with rhinitis. The ARIA-pharmacy ICP includes a diagnostic questionnaire specifically focusing attention on key symptoms and markers of the disease, a systematic Diagnosis Guide (including differential diagnoses) and a simple flowchart with proposed treatment for rhinitis and asthma multimorbidity. Key prompts for referral within the ICP are included. The use of technology is critical to enhance the management of AR. However, the ARIA-pharmacy ICP should be adapted to local health care environments/situations as regional (national) differences exist in pharmacy care.

[1]  S. Madden,et al.  Aria , 2020, Proceedings of the VLDB Endowment.

[2]  D. Price,et al.  The Burden of Rhinitis and the Impact of Medication Management within the Community Pharmacy Setting. , 2018, The journal of allergy and clinical immunology. In practice.

[3]  A. Sheikh,et al.  Treatment of allergic rhinitis using mobile technology with real‐world data: The MASK observational pilot study , 2018, Allergy.

[4]  D. Ryan,et al.  Lack of asthma and rhinitis control in general practitioner-managed patients prescribed fixed-dose combination therapy in Australia , 2018, The Journal of asthma : official journal of the Association for the Care of Asthma.

[5]  Sinthia Bosnic-Anticevich,et al.  Tell me about your hay fever: a qualitative investigation of allergic rhinitis management from the perspective of the patient , 2018, npj Primary Care Respiratory Medicine.

[6]  Stephen R. Williams,et al.  Transfer of innovation on allergic rhinitis and asthma multimorbidity in the elderly (MACVIA‐ARIA) ‐ EIP on AHA Twinning Reference Site (GARD research demonstration project) , 2018, Allergy.

[7]  D. Price,et al.  Identifying the hidden burden of allergic rhinitis (AR) in community pharmacy: a global phenomenon , 2017, Asthma Research and Practice.

[8]  A. Sheikh,et al.  CHRODIS criteria applied to the MASK (MACVIA-ARIA Sentinel NetworK) Good Practice in allergic rhinitis: a SUNFRAIL report , 2017, Clinical and Translational Allergy.

[9]  M. Shakeel,et al.  Does intranasal steroid spray technique affect side effects and compliance? Results of a patient survey , 2017, The Journal of Laryngology & Otology.

[10]  P. Cullinan,et al.  Impact of Rhinitis on Work Productivity: A Systematic Review. , 2017, The journal of allergy and clinical immunology. In practice.

[11]  Joaquim Mullol,et al.  Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines—2016 revision , 2017, The Journal of allergy and clinical immunology.

[12]  J. Bousquet,et al.  Work productivity in rhinitis using cell phones: The MASK pilot study , 2017, Allergy.

[13]  O. Mayora,et al.  Validation of the MASK‐rhinitis visual analogue scale on smartphone screens to assess allergic rhinitis control , 2017, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[14]  D. Ryan,et al.  Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis – A EUFOREA‐ARIA‐EPOS‐AIRWAYS ICP statement , 2017, Allergy.

[15]  D. Price,et al.  Seasonal patterns of oral antihistamine and intranasal corticosteroid purchases from Australian community pharmacies: a retrospective observational study , 2017, Pragmatic and observational research.

[16]  A. Sheikh,et al.  The Work Productivity and Activity Impairment Allergic Specific (WPAI-AS) Questionnaire Using Mobile Technology: The MASK Study. , 2017, Journal of investigational allergology & clinical immunology.

[17]  D. Wallace,et al.  Seasonal Allergic Rhinitis: A focused systematic review and practice parameter update. , 2017, Current opinion in allergy and clinical immunology.

[18]  A. Mari,et al.  Diagnosing allergic sensitizations in the third millennium: why clinicians should know allergen molecule structures , 2017, Clinical and Translational Allergy.

[19]  W. Fokkens,et al.  Endotype-driven treatment in chronic upper airway diseases , 2017, Clinical and Translational Allergy.

[20]  S. Durham,et al.  BSACI guideline for the diagnosis and management of allergic and non‐allergic rhinitis (Revised Edition 2017; First edition 2007) , 2017, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[21]  M. Wensing,et al.  Self-management research of asthma and good drug use (SMARAGD study): a pilot trial , 2017, International Journal of Clinical Pharmacy.

[22]  B. Yawn,et al.  Management of allergic rhinitis in the era of effective over-the-counter treatments , 2017, Postgraduate medicine.

[23]  P Demoly,et al.  Pilot study of mobile phone technology in allergic rhinitis in European countries: the MASK‐rhinitis study , 2017, Allergy.

[24]  J. Bousquet,et al.  Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report , 2017, Clinical and Translational Allergy.

[25]  C. Schneider,et al.  Community pharmacy modifications to non‐prescription medication requests: A simulated patient study , 2017, Research in social & administrative pharmacy : RSAP.

[26]  D. Price,et al.  Medication-related costs of rhinitis in Australia: a NostraData cross-sectional study of pharmacy purchases , 2017, Journal of asthma and allergy.

[27]  E. Meltzer,et al.  Findings from an Online Survey Assessing the Burden and Management of Seasonal Allergic Rhinoconjunctivitis in US Patients. , 2017, The journal of allergy and clinical immunology. In practice.

[28]  Ludger Klimek,et al.  Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care , 2017, Allergo Journal International.

[29]  Todor A Popov,et al.  ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle , 2016, Clinical and Translational Allergy.

[30]  S. Chao,et al.  Comparison of the distribution of intranasal steroid spray using different application techniques , 2016, International forum of allergy & rhinology.

[31]  D. Postma,et al.  Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5) , 2016, Clinical and Translational Allergy.

[32]  T. Chen,et al.  Education and Assessment of Pharmacists on the Use of the Drug Burden Index in Older Adults Using a Continuing Professional Development Education Method , 2016, American Journal of Pharmaceutical Education.

[33]  J. Bousquet,et al.  AIRWAYS-ICPs (European Innovation Partnership on Active and Healthy Ageing) from concept to implementation , 2016, European Respiratory Journal.

[34]  G. Canonica,et al.  360 degree perspective on allergic rhinitis management in Italy: a survey of GPs, pharmacists and patients , 2015, Clinical and Molecular Allergy.

[35]  F. Rodenas,et al.  MACVIA‐ARIA Sentinel NetworK for allergic rhinitis (MASK‐rhinitis): the new generation guideline implementation , 2015, Allergy.

[36]  J. Bousquet,et al.  A common language to assess allergic rhinitis control: results from a survey conducted during EAACI 2013 Congress , 2015, Clinical and Translational Allergy.

[37]  T. Kyle,et al.  Understanding the role of the healthcare professional in patient self-management of allergic rhinitis , 2015, SAGE open medicine.

[38]  G. Canonica,et al.  Catching allergy by a simple questionnaire , 2015, The World Allergy Organization journal.

[39]  G. Canonica,et al.  The patient with rhinitis in the pharmacy. A cross-sectional study in real life , 2015, Asthma Research and Practice.

[40]  B. Bender.  Motivating Patient Adherence to Allergic Rhinitis Treatments , 2015, Current Allergy and Asthma Reports.

[41]  J. Bousquet,et al.  Clinical Relevance of Cluster Analysis in Phenotyping Allergic Rhinitis in a Real-Life Study , 2015, International Archives of Allergy and Immunology.

[42]  R. Gerth van Wijk,et al.  The minimal clinically important difference of the control of allergic rhinitis and asthma test (CARAT): cross-cultural validation and relation with pollen counts , 2015, npj Primary Care Respiratory Medicine.

[43]  I. Iakovidis,et al.  The European Innovation Partnership on Active and Healthy Ageing: The European geriatric medicine introduces the EIP on AHA column , 2014 .

[44]  I. Annesi-Maesano,et al.  Monitoring of occupational and environmental aeroallergens – EAACI Position Paper , 2014, Allergy.

[45]  M. Blaiss,et al.  Current Allergic Rhinitis Experiences Survey (CARES): Consumers' awareness, attitudes and practices. , 2014, Allergy and asthma proceedings.

[46]  D. Wang,et al.  The status quo and unmet needs in the management of allergic rhinitis and chronic rhinosinusitis: a Malaysian perspective , 2014, Asia Pacific allergy.

[47]  D. Postma,et al.  Integrated care pathways for airway diseases (AIRWAYS-ICPs) , 2014, European Respiratory Journal.

[48]  G. Rachelefsky,et al.  Are you comfortable with over-the-counter intranasal steroids for children? A call to action. , 2014, The journal of allergy and clinical immunology. In practice.

[49]  J. Fonseca,et al.  Evaluation of Allergic Rhinitis and Asthma Control in a Portuguese Community Pharmacy Setting , 2014, Journal of managed care & specialty pharmacy.

[50]  Lorraine D Smith,et al.  Strategies for the management of intermittent allergic rhinitis: an Australian study , 2014, Health expectations : an international journal of public participation in health care and health policy.

[51]  G. Karakaya,et al.  Protective efficacy of sunglasses on the conjunctival symptoms of seasonal rhinitis , 2013, International forum of allergy & rhinology.

[52]  L. Côté,et al.  Collaboration between family physicians and community pharmacists: opinions of graduates in family medicine. , 2013, Canadian family physician Medecin de famille canadien.

[53]  J. Bousquet,et al.  Prevalence and classification of rhinitis in the elderly: a nationwide survey in Portugal , 2013, Allergy.

[54]  A. Sheikh,et al.  ‘Help for Hay Fever’, a goal-focused intervention for people with intermittent allergic rhinitis, delivered in Scottish community pharmacies: study protocol for a pilot cluster randomized controlled trial , 2013, Trials.

[55]  G. Canonica,et al.  Sublingual immunotherapy for allergic rhinitis and conjunctivitis. , 2013, Immunotherapy.

[56]  Tiago Jacinto,et al.  Control of Allergic Rhinitis and Asthma Test (CARAT): dissemination and applications in primary care , 2013, Primary care respiratory journal : journal of the General Practice Airways Group.

[57]  N. Ahuja,et al.  The Smartphone in Medicine: A Review of Current and Potential Use Among Physicians and Students , 2012, Journal of medical Internet research.

[58]  S. Bosnic-Anticevich,et al.  Experiences of community pharmacists involved in the delivery of a specialist asthma service in Australia , 2012, BMC Health Services Research.

[59]  J. Schroeder,et al.  Nasal saline irrigation in children: a study of compliance and tolerance. , 2012, International journal of pediatric otorhinolaryngology.

[60]  D. Postma,et al.  Severe Chronic Allergic (and Related) Diseases: A Uniform Approach – A MeDALL – GA2LEN – ARIA Position Paper , 2012, International Archives of Allergy and Immunology.

[61]  Simon P. W. Schmitt,et al.  Assessment of a computerised decision support system for allergic rhino-conjunctivitis counselling in German pharmacy , 2012, International Journal of Clinical Pharmacy.

[62]  B. Saini,et al.  The role of non-clinicians in a goal setting model for the management of allergic rhinitis in community pharmacy settings. , 2011, Patient education and counseling.

[63]  P. Demoly,et al.  Validation of a self‐questionnaire for assessing the control of allergic rhinitis , 2011, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[64]  J. Mullol,et al.  Validation of ARIA (Allergic Rhinitis and its Impact on Asthma) classification in a pediatric population: The PEDRIAL study , 2011, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[65]  F Kauffmann,et al.  MeDALL (Mechanisms of the Development of ALLergy): an integrated approach from phenotypes to systems medicine , 2011, Allergy.

[66]  Martyn R Partridge,et al.  Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. , 2010, The Journal of allergy and clinical immunology.

[67]  Holger J Schünemann,et al.  Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. , 2010, The Journal of allergy and clinical immunology.

[68]  J. Bousquet,et al.  Validation of a questionnaire (CARAT10) to assess rhinitis and asthma in patients with asthma , 2010, Allergy.

[69]  J. Bousquet,et al.  Efficacy of Desloratadine in Persistent Allergic Rhinitis – A GA2LEN Study , 2010, International Archives of Allergy and Immunology.

[70]  J. Mullol,et al.  Validation of ARIA duration and severity classifications in Spanish allergic rhinitis patients - The ADRIAL cohort study. , 2010, Rhinology.

[71]  M. Rottem.  [Allergic rhinitis and its impact on asthma]. , 2010, Harefuah.

[72]  Anand A. Dalal,et al.  Psychometric validation of the rhinitis control assessment test: a brief patient-completed instrument for evaluating rhinitis symptom control. , 2010, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[73]  J. Bousquet,et al.  Allergic rhinitis and its impact on asthma update (ARIA 2008)--western and Asian-Pacific perspective. , 2009, Asian Pacific journal of allergy and immunology.

[74]  J. Bousquet,et al.  Efficacy of desloratadine in intermittent allergic rhinitis: a GA2LEN study , 2009, Allergy.

[75]  J. Bousquet,et al.  [Allergic rhinitis and its impact upon asthma--update (ARIA 2008). Romanian perspective]. , 2009, Pneumologia.

[76]  J. Bousquet,et al.  Unmet needs in severe chronic upper airway disease (SCUAD). , 2009, The Journal of allergy and clinical immunology.

[77]  J. Fonseca,et al.  The Development , 2009 .

[78]  J. Mullol,et al.  Persistent allergic rhinitis has a moderate impact on the sense of smell, depending on both nasal congestion and inflammation , 2009, The Laryngoscope.

[79]  Josep Maria Haro,et al.  Comparison of Population Health Status in Six European Countries: Results of a Representative Survey Using the EQ-5D Questionnaire , 2009, Medical care.

[80]  J. Bousquet,et al.  Allergic rhinitis management pocket reference 2008 * , 2008, Allergy.

[81]  J. Bousquet,et al.  [Allergic rhinitis and its impact on asthma update (ARIA 2008). The Turkish perspective]. , 2008, Tuberkuloz ve toraks.

[82]  Todor A Popov,et al.  Common characteristics of upper and lower airways in rhinitis and asthma: ARIA update, in collaboration with GA2LEN , 2007, Allergy.

[83]  S. Durham,et al.  Allergic rhinitis and its impact on asthma update: allergen immunotherapy. , 2007, The Journal of allergy and clinical immunology.

[84]  J. Bousquet,et al.  Original article: Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines , 2007, Allergy.

[85]  R. Hansen,et al.  Evaluation of Product Switching After a State Medicaid Program Began Covering Loratadine OTC 1 Year After Market Availability , 2006, Journal of managed care pharmacy : JMCP.

[86]  J. Hay,et al.  Cost and utilization impacts of oral antihistamines in the California Medi-Cal program. , 2005, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[87]  G. Sambataro,et al.  Nasal Rinsing with Hypertonic Solution: An Adjunctive Treatment for Pediatric Seasonal Allergic Rhinoconjunctivitis , 2005, International Archives of Allergy and Immunology.

[88]  K. Nair,et al.  The effect of the Rx-to-OTC switch of loratadine and changes in prescription drug benefits on utilization and cost of therapy. , 2005, The American journal of managed care.

[89]  J. Bousquet,et al.  Characteristics of intermittent and persistent allergic rhinitis: DREAMS study group , 2005, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[90]  H. Reddel,et al.  The reduction of rhinitis symptoms by nasal filters during natural exposure to ragweed and grass pollen , 2005, Allergy.

[91]  G. Solley,et al.  Clinical update , 2022 .

[92]  J. Alió,et al.  The Economic and Quality of Life Impact of Seasonal Allergic Conjunctivitis in a Spanish Setting , 2005, Ophthalmic epidemiology.

[93]  P. Howarth,et al.  ARIA in the pharmacy: management of allergic rhinitis symptoms in the pharmacy , 2004, Allergy.

[94]  P. Demoly,et al.  The ARIA score of allergic rhinitis using mobile technology correlates with quality-of-life: The MASK study , 2017 .

[95]  OTC fluticasone furoate nasal spray (Flonase Sensimist) for allergic rhinitis. , 2017, The Medical letter on drugs and therapeutics.

[96]  J. Bousquet,et al.  MASK-rhinitis, a single tool for integrated care pathways in allergic rhinitis. , 2015, World hospitals and health services : the official journal of the International Hospital Federation.

[97]  J. Virchow,et al.  Effectiveness of MP29-02 for the treatment of allergic rhinitis in real-life: results from a noninterventional study. , 2015, Allergy and asthma proceedings.

[98]  G. Canonica,et al.  Sublingual immunotherapy: recent advances. , 2013, Allergology international : official journal of the Japanese Society of Allergology.

[99]  Yu-zhi Chen,et al.  [Allergic Rhinitis and its Impact on Asthma (ARIA) achievements in 10 years and future needs]. , 2012, Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery.

[100]  G. Christiaens,et al.  Leading change , 2018, Leadership Transitions in Universities.

[101]  J. Bousquet,et al.  [Allergic rhinitis and its impact on asthma (ARIA update 2008). The Austrian perspective]. , 2009, Wiener medizinische Wochenschrift.

[102]  J. Bousquet,et al.  [Allergic rhinitis update and its impact on asthma (ARIA 2008). Latin American perspective]. , 2009, Revista alergia Mexico.

[103]  S. Bosnic-Anticevich,et al.  Healthcare professional versus patient goal setting in intermittent allergic rhinitis. , 2008, Patient education and counseling.

[104]  J. Bousquet,et al.  Allergic Rhinitis and its impact on asthma update (ARIA 2008). The Belgian perspective. , 2008, B-ENT.

[105]  J. Bousquet,et al.  Allergic Rhinitis and its Impact on Asthma update (ARIA 2008). The perspective from Spain. , 2008, Journal of investigational allergology & clinical immunology.

[106]  Bashar Allaf,et al.  Severity and impairment of allergic rhinitis in patients consulting in primary care. , 2006, The Journal of allergy and clinical immunology.