Author:
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Bousquet, Jean; Devillier, P.; Antó i Boqué, Josep Maria; Bewick, M.; Haahtela, T.; Arnavielhe, S.; Bedbrook, A.; Murray, R.; van Eerd, M.; Fonseca, J. A.; Morais Almeida, M.; Todo Bom, A.; Menditto, E.; Passalacqua, G.; Stellato, C.; Triggiani, M.; Ventura, M. T.; Vezzani, G.; Annesi-Maesano, Isabella; Bourret, R.; Bosse, I.; Caimmi, D.; Cartier, C.; Demoly, P.; Just, J.; Portejoie, F.; Siroux, V.; Viart, F.; Bergmann, K. C.; Keil, T.; Klimek, L.; Mösges, R.; Pfaar, O.; Shamai, S.; Zuberbier, T.; Mullol, J.; Valero, Antonio; Spranger, O.; Tomazic, P. V.; Kowalski, M. L.; Kuna, P.; Kupczyk, M.; Raciborski, F.; Samolinski, B.; Toppila Salmi, S. K.; Valovirta, E.; Cruz, A. A.; Sarquis Serpa, F.; da Silva, J.; Stelmach, R.; Larenas Linnemann, D.; Rodríguez González, M.; Burguete Cabañas, M. T.; Kvedariene, V.; Valiulis, A.; Chavannes, N. H.; Fokkens, W. J.; Ryan, D.; Sheikh, A.; Bachert, C.; Hellings, P. W.; VandenPlas, O.; Ballardini, N.; Kull, I.; Melén, E.; Wickman, Magnus; Bindslev Jensen, C.; Eller, E.; Bosnic-Anticevich, S.; O'Hehir, R. E.; Agache, I.; Bieber, T.; Casale, T.; Gemicioğlu, B.; Ivancevich, J. C.; Vries, G. De; Sorensen, M.; Yorgancioglu, A.; Laune, D.; Westman, M.; MACVIA working group
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Abstract:
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Background: Multimorbidity in allergic airway diseases is well known, but no data exist about the
daily dynamics of symptoms and their impact on work. To better understand this, we aimed to assess
the presence and control of daily allergic multimorbidity (asthma, conjunctivitis, rhinitis) and its
impact on work productivity using a mobile technology, the Allergy Diary,
Methods: We undertook a one year prospective observational study in which 4,210 users and 32,585
days were monitored in 19 countries. Five visual analogue scales (VAS) assessed the daily burden of
the disease (i.e. global evaluation, nose, eyes, asthma and work). VAS levels <20/100 were
categorized as “Low” burden and VAS levels ≥50/100 as “High” burden. Results: VAS global measured levels assessing the global control of the allergic disease were
significantly associated with allergic multimorbidity. Eight hypothesis-driven patterns were defined
based on “Low” and “High” VAS levels. There were <0.2% days of Rhinitis Low and Asthma High
or Conjunctivitis High patterns. There were 5.9% days with a Rhinitis High - Asthma Low pattern.
There were 1.7% days with a Rhinitis High – Asthma High – Conjunctivitis Low pattern. A novel
Rhinitis High - Asthma High - Conjunctivitis High pattern was identified in 2.9% days and had the
greatest impact on uncontrolled VAS global measured and impaired work productivity. Work
productivity was significantly correlated with VAS global measured levels.
Conclusions: In a novel approach examining daily symptoms with mobile technology we found
considerable intra-individual variability of allergic multimorbidity including a previously
unrecognized extreme pattern of uncontrolled multimorbidity. |