[en] BACKGROUND: Co-medication is common among patients with allergic rhinitis (AR), but its dimension and patterns are unknown. This is particularly relevant since AR is understood differently across European countries, as reflected by rhinitis-related search patterns in Google Trends. This study aims to assess AR co-medication and its regional patterns in Europe, using real-world data. METHODS: We analysed 2015-2020 MASK-air(®) European data. We compared days under no medication, monotherapy and co-medication using the visual analogue scale (VAS) levels for overall allergic symptoms ('VAS Global Symptoms') and impact of AR on work. We assessed the monthly use of different medication schemes, performing separate analyses by region (defined geographically or by Google Trends patterns). We estimated the average number of different drugs reported per patient within 1 year. RESULTS: We analysed 222,024 days (13,122 users), including 63,887 days (28.8%) under monotherapy and 38,315 (17.3%) under co-medication. The median 'VAS Global Symptoms' was 7 for no medication days, 14 for monotherapy and 21 for co-medication (p < .001). Medication use peaked during the spring, with similar patterns across different European regions (defined geographically or by Google Trends). Oral H(1) -antihistamines were the most common medication in single and co-medication. Each patient reported using an annual average of 2.7 drugs, with 80% reporting two or more. CONCLUSIONS: Allergic rhinitis medication patterns are similar across European regions. One third of treatment days involved co-medication. These findings suggest that patients treat themselves according to their symptoms (irrespective of how they understand AR) and that co-medication use is driven by symptom severity.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Sousa-Pinto, Bernardo ; MEDCIDS - Department of Community Medicine, Information and Health Decision ; CINTESIS - Center for Health Technology and Services Research, University of ; RISE - Health Research Network, University of Porto, Porto, Portugal.
Sá-Sousa, Ana; MEDCIDS - Department of Community Medicine, Information and Health Decision ; CINTESIS - Center for Health Technology and Services Research, University of ; RISE - Health Research Network, University of Porto, Porto, Portugal.
Vieira, Rafael José ; MEDCIDS - Department of Community Medicine, Information and Health Decision ; CINTESIS - Center for Health Technology and Services Research, University of ; RISE - Health Research Network, University of Porto, Porto, Portugal.
Amaral, Rita ; MEDCIDS - Department of Community Medicine, Information and Health Decision ; CINTESIS - Center for Health Technology and Services Research, University of ; RISE - Health Research Network, University of Porto, Porto, Portugal.
Klimek, Ludger ; Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, ; Center for Rhinology and Allergology, Wiesbaden, Germany.
Czarlewski, Wienczyslawa; Medical Consulting Czarlewski, Levallois, France. ; MASK-air, Montpellier, France.
Antó, Josep M; ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain. ; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. ; Universitat Pompeu Fabra (UPF), Barcelona, Spain. ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Pfaar, Oliver ; Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology
Bedbrook, Anna; MASK-air, Montpellier, France.
Kvedariene, Violeta; Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine,
Ventura, Maria Teresa; University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari,
Ansotegui, Ignacio J; Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao,
Bergmann, Karl-Christian; Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member ; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP,
Brussino, Luisa; Department of Medical Sciences, Allergy and Clinical Immunology Unit, University
Canonica, G Walter; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy. ; Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center
Cardona, Victoria ; Allergy Section, Department of Internal Medicine, Hospital Vall d'Hebron &
Carreiro-Martins, Pedro ; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar ; NOVA Medical School/Comprehensive Health Research Center (CHRC), Lisbon
Casale, Tomas; Division of Allergy/Immunology, University of South Florida, Tampa, Florida, USA.
Cecchi, Lorenzo ; SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
Chivato, Tomás; School of Medicine, University CEU San Pablo, Madrid, Spain.
Chu, Derek K; Department of Medicine and Health Research Methods, Evidence & Impact, McMaster
Cingi, Cemal ; Eskisehir Osmangazi University, Medical Faculty, ENT Department, Eskisehir
Costa, Elísio M; UCIBIO, REQUINTE, Faculty of Pharmacy and Competence Center on Active and Healthy
Cruz, Alvaro A ; Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group
De Feo, Giulia; Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana",
Devillier, Philippe ; VIM Suresnes, UMR_0892, Pôle des Maladies des Voies Respiratoires, Hôpital Foch
Fokkens, Wytske J; Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location
Gaga, Mina; ERS President 2017-2018, 7th Resp Med Department and Asthma Center, Athens Chest
Gemicioğlu, Bilun; Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa
Haahtela, Tari ; Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki
Ivancevich, Juan Carlos; Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
Ispayeva, Zhanat; Department of Allergology and Clinical Immunology of the Kazakh National Medical
Jutel, Marek; Department of Clinical Immunology, Wrocław Medical University, Wroclaw, Poland. ; Department of Clinical Immunology, ALL-MED Medical Research Institute, Wrocław,
Kuna, Piotr; Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital,
Kaidashev, Igor; Poltava State Medical University, Poltava, Ukraine.
Kraxner, Helga; Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University,
Larenas-Linnemann, Désirée E ; Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and
Laune, Daniel; KYomed INNOV, Montpellier, France.
Lipworth, Brian; Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine,
Louis, Renaud ; Centre Hospitalier Universitaire de Liège - CHU > > Service de pneumologie - allergologie
Makris, Michael; Allergy Unit "D Kalogeromitros", 2nd Department of Dermatology and Venereology,
Monti, Riccardo; Department of Medical Sciences, Allergy and Clinical Immunology Unit, University
Morais-Almeida, Mario ; Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
Mösges, Ralph; IMSB, Medical Faculty, University of Cologne, and ClinCompetence Cologne GmbH,
Mullol, Joaquim; Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Clinical &
Odemyr, Mikaëla; EFA European Federation of Allergy and Airways Diseases Patients' Associations,
Okamoto, Yoshitaka; Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
Papadopoulos, Nikolaos G ; Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
Patella, Vincenzo ; Division of Allergy and Clinical Immunology, Department of Medicine, Agency of
Pham-Thi, Nhân; Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des
Regateiro, Frederico S; Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de
Reitsma, Sietze; Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location
Rouadi, Philip W ; Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University
Samolinski, Boleslaw; Department of Prevention of Environmental Hazards, Allergology and Immunology,
Sova, Milan; Department of Pulmonary medicine and tuberculosis, University Hospital Brno,
Todo-Bom, Ana; Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University
Taborda-Barata, Luis; Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal. ; UBIAir - Clinical & Experimental Lung Centre, University of Beira Interior, ; Department of Immunoallergology, Cova da Beira University Hospital Centre,
Tomazic, Peter Valentin ; Department of General ORL, H&NS, Medical University of Graz, ENT-University
Toppila-Salmi, Sanna; Skin and Allergy Hospital, Helsinki University Hospital, and University of
Sastre, Joaquin; Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of
Tsiligianni, Ioanna; Health Planning Unit, Department of Social Medicine, Faculty of Medicine,
Valiulis, Arunas; Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty
Vandenplas, Olivier ; Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur
Wallace, Dana; Nova Southeastern University, Fort Lauderdale, Florida, USA.
Waserman, Susan; Department of Medicine, Clinical Immunology and Allergy, McMaster University,
Yorgancioglu, Arzu; Department of Pulmonology, Celal Bayar University, Manisa, Turkey.
Zidarn, Mihaela; University Clinic of Respiratory and Allergic Diseases, Golnick, and University
Zuberbier, Torsten ; Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member ; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP
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