The number of allergic patients is increasing all over the world, also in Hungary.
Delivering effective and cost-effective health care is essential for all health care
systems. ARIA (Allergic Rhinitis and its Impact on Asthma) aims to improve the care
of patients who suffer from allergic rhinitis by setting up guidelines and updating
them. Development of ICPs (integrated care pathways) can play an essential role in
attaining this goal. Our aim is to make ICP-s developed by ARIA available also in
Hungary, as is already the case in other countries of the European Union (EU). Together
with other international initiatives, ARIA has worked out digitally-enabled ICPs to
support care in allergic rhinitis and comorbid asthma. ICPs are based on new-generation
guidelines using RWE (real-world evidence) from chamber studies and mobile technology.
The MASK (Mobile Airways Sentinel NetworK) algorithm - based on visual analogue scale
- was digitalized to support pharmacotherapy, and was refined by using RWE. ARIA was
the first to develop ICPs for allergen immunotherapy (AIT) in 2019. Based on MASK
data, patients did not follow guidelines and their adherence to treatment was poor.
Patients would modify their treatments, depending on the disease control. The effect
of fluticasone propionate-azelastine combination is superior to intranasal corticosteroids
which are superior to oral H-1-antihistamines. Electronic diaries obtained from cell
phones and other 'mobile health' (mHealth) devices help select patients for AIT. The
ARIA algorithm for AR was found appropriate and no change is necessary. These guidelines
will inform ICPs and will be included in the DG Sante digitally-enabled, person-centred
care system. AIT is an effective treatment for allergic diseases caused by inhaled
allergens. Its use should, however, be restricted to carefully selected patients.
