scholarly journals ARIA guideline 2019: treatment of allergic rhinitis in the German health system

2019 ◽  
Vol 28 (7) ◽  
pp. 255-276 ◽  
Author(s):  
Ludger Klimek ◽  
Claus Bachert ◽  
Oliver Pfaar ◽  
Sven Becker ◽  
Thomas Bieber ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Health System ◽  
Integrated Care ◽  
Respiratory Diseases ◽  
Social Systems ◽  
Real Life ◽  
Care Pathways ◽  
Chronic Respiratory Diseases ◽  
Number Of Patients ◽  
Integrated Care Pathways

Abstract Background The number of patients affected by allergies is increasing worldwide. The resulting allergic diseases are leading to significant costs for health care and social systems. Integrated care pathways are needed to enable comprehensive care within the national health systems. The ARIA (Allergic Rhinitis and its Impact on Asthma) initiative develops internationally applicable guidelines for allergic respiratory diseases. Methods ARIA serves to improve the care of patients with allergies and chronic respiratory diseases. In collaboration with other international initiatives, national associations and patient organizations in the field of allergies and respiratory diseases, real-life integrated care pathways have been developed for a digitally assisted, integrative, individualized treatment of allergic rhinitis (AR) with comorbid asthma. In the present work, these integrated care pathways have been adapted to the German situation and health system. Results The present ICP (integrated care pathways) guideline covers key areas of the care of AR patients with and without asthma. It includes the views of patients and other healthcare providers. Discussion A comprehensive ICP guideline can reflect real-life care better than traditional guideline models.

INTEGRATED CARE PATHWAYS IN LUNG CANCER: A QUALITY IMPROVEMENT PROJECT

2018 ◽  
Vol 34 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Gianpiero Fasola ◽  
Jessica Menis ◽  
Alessandro Follador ◽  
Elisa De Carlo ◽  
Francesca Valent ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Quality Improvement ◽  
Integrated Care ◽  
Real Life ◽  
University Hospital ◽  
Care Pathways ◽  
Improvement Project ◽  
Managerial Skills ◽  
Integrated Care Pathways ◽  
Nsclc Patients

Background:Non small cell lung cancer (NSCLC) diagnosis and treatment is a highly complex process, requiring managerial skills merged with clinical knowledge and experience. Integrated care pathways (ICPs) might be a good strategy to overview and improve patient's management. The aim of this study was to review the ICPs of NSCLC patients in a University Hospital and to identify areas of quality improvement.Materials and Methods:The electronic medical records of 169 NSCLC patients visited at the University Hospital were retrospectively reviewed. Quality of care (QoC) has been measured trough fifteen indicators, selected according main international Guidelines and approved by the multi-disciplinary team for thoracic malignancies. Results have been compared with those of a similar retrospective study conducted at the same hospital in 2008.Results:A total of 146 patients were considered eligible. Eight of fifteen indicators were not in line with the benchmarks. We compared the results obtained in the two separate periods. Moreover, we process some proposal to be discussed with the general management of the hospital, aimed to redesign NSCLC care pathways.Conclusions:ICPs confirm to be feasible and to be an effective tool in real life. The periodic measurement of QoC indicators is necessary to ensure clinical governance of patients pathways.

scholarly journals ПРОЕКТ “ARIA”: ШЛЯХИ НАДАННЯ МЕДИЧНОЇ ДОПОМОГИ ПРИ АЛЕРГІЧНОМУ РИНІТІ (2019 РІК) – УКРАЇНА

2019 ◽  
Vol 23 (5-6) ◽  
pp. 3-14
Author(s):  
І. Гогунська ◽  
Д. Заболотна ◽  
С. Зайков ◽  
И. Кайдашев ◽  
Т. Уманець ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Integrated Care ◽  
Real Life ◽  
Evaluation Methodology ◽  
Care Pathways ◽  
Next Generation ◽  
Sentinel Network ◽  
Care Plans ◽  
Airway Diseases ◽  
Integrated Care Pathways

In all societies, the burden and cost of allergic diseases are increasing rapidly, and change management strategies are needed to support the transformation of the health care system for integrated care. A meeting was held in Paris, December 3, 2018 for chronic disease care. It was organised by MASK (Mobile Airways Sentinel NetworK) and POLLAR (Impact of Air Pollution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases. The evaluation of real-life Integrated Care Pathways (ICPs) was recommended fordigitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity embedding environmental exposure. ICPs are structured multi-disciplinary care plans detailing key steps of patient care. They promote the translation of guideline recommendations into local protocols and their application to clinical practice. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology explicitly considers all types of study designs but guideline developers often prefer to restrict guidelines to RCTs. GRADE also considers evidence about values and preferences, acceptability and feasibility or directness of findings. There is an increasing trend to use real-world evidence (RWE) to inform clinical practice. AIRWAYS ICPs (Integrated care pathways for airway diseases) were the first steps towards the development of ICPs for rhinitis and asthma multimorbidity. During the Paris meeting, next-generation guidelines for the pharmacologic treatment of AR were developed using existing GRADE-based guidelines for AR tested using RWE provided by mobile technology and chamber studies. These recommendations were used to refine the MASK algorithm for AR treatment proposed by a consensus group. In allergic rhinitis (AR), there is an urgent need to develop next-generation guidelines for pharmacotherapy and ICPs for allergen immunotherapy (AIT). Two separate documents were produced following the Paris meeting. This paper clarifies the ways of implementing this direction in Ukraine.

scholarly journals ARIA 2019: Um Percurso Assistencial Integrado para a Rinite Alérgica em Portugal

2020 ◽  
Vol 33 (13) ◽  
Author(s):  
João Fonseca ◽  
Tiago Taveira-Gomes ◽  
Ana Margarida Pereira ◽  
Manuel Branco-Ferreira ◽  
Pedro Carreiro-Martins ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Integrated Care ◽  
Allergen Immunotherapy ◽  
Care Pathway ◽  
Response Monitoring ◽  
Care Pathways ◽  
The European Union ◽  
Levels Of Care ◽  
Integrated Care Pathways ◽  
Grade Methodology

The Allergic Rhinitis and Its Impact on Asthma (ARIA) initiative started more than 20 years ago and has developed and disseminated evidence-based guidelines and projects in the field of allergic rhinitis. This initiative is currently focused on providing patient-centred guidelines that contribute to an integrated care pathway between the various levels of care and take advantage of digital solutions, and the introduction of integrated care pathways in clinical practice has been recommended. In this article we describe the adaptation for Portugal of the ARIA Integrated Care Pathways document. After a brief review of the epidemiology and impact of allergic rhinitis in Portugal and the activities carried out in Portugal within the ARIA initiative, we describe the broad knowledge base used for the development of recommendations for the pharmacological treatment of allergic rhinitis, and these recommendations are based on the GRADE methodology, real world evidence acquired by mobile technology (mHealth) and resulting from allergenic exposure chamber studies. What follows is a summary of integrated care pathways for allergen immunotherapy produced in 2019. Allergen immunotherapy is considered an example of precision medicine where the use of mHealth technologies will improve stratification for patient selection and response monitoring. These recommendations were considered as best practices of integrated patient-centred care supported by digital systems from Directorate General for Health and Food Safety of the European Union (DG Santé) and represent the ARIA Phase4 Change Management strategy.

scholarly journals Asthma prevalence and associated factors among lebanese adults: the first national survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zeina Akiki ◽  
Danielle Saadeh ◽  
Rita Farah ◽  
Souheil Hallit ◽  
Hala Sacre ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Family History ◽  
Respiratory Diseases ◽  
Fruits And Vegetables ◽  
Asthma Prevalence ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Current Asthma ◽  
Chronic Respiratory Diseases ◽  
History Of

Abstract Background No national research has yet explored the prevalence of asthma among adults in Lebanon. This study aims to evaluate the prevalence of physician-diagnosed asthma and current asthma, and their determinants among Lebanese adults 16 years old or above. Methods A cross-sectional study was carried out using a multistage cluster sampling. The questionnaire used collected information on asthma, respiratory symptoms, and risk factors. Results The prevalence of physician-diagnosed asthma was 6.7% (95% CI 5–8.7%), and that of current asthma was 5% (95% CI 3.6–6.9%). Chronic symptoms such as cough, wheezing, and shortness of breath were worst at night. Factors positively associated with physician-diagnosed asthma were a secondary educational level (adjusted OR, aOR = 4.45), a family history of chronic respiratory diseases (aOR = 2.78), lung problems during childhood (15.9), and allergic rhinitis (4.19). Additionally, consuming fruits and vegetables less than once per week (3.36), a family history of chronic respiratory diseases (3.92), lung problems during childhood (9.43), and allergic rhinitis (8.12) were positively associated with current asthma. Conclusions The prevalence of asthma was within the range reported from surrounding countries. However, repeated cross-sectional studies are necessary to evaluate trends in asthma prevalence in the Lebanese population.

Integrated Care Pathways: An Orthopaedic Experience

Physiotherapy ◽  
1996 ◽  
Vol 82 (1) ◽  
pp. 28-30 ◽  
Author(s):  
P POOLE ◽  
S JOHNSON
Keyword(s):  
Integrated Care ◽  
Care Pathways ◽  
Integrated Care Pathways

scholarly journals Chronic respiratory diseases at primary health care level in Georgia: the results of the pilot study

2016 ◽  
Vol 71 (4) ◽  
Author(s):  
I. Chkhaidze ◽  
T. Maglakelidze ◽  
N. Khaltaev
Keyword(s):  
Allergic Rhinitis ◽  
Respiratory Diseases ◽  
Chronic Obstructive ◽  
Official Statistics ◽  
Global Alliance ◽  
Care Level ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Chronic Morbidity ◽  
Official Data

Background and aim. Millions of people suffer from chronic respiratory diseases (CRD). To address this serious global health problem WHO formed the Global Alliance against Chronic Respiratory Diseases (GARD). Chronic obstructive pulmonary disease (COPD) is a major priority of GARD due to high chronic morbidity and mortality; however, there is still little prevalence data available. The prevalence of COPD in Georgia, as well as other CRD, is suspected to be high. Methods. GARD Pilot Survey (GAPS) in Georgia had been carried out by the Georgian Respiratory Association. The survey was conducted in the Sagarejo and Mtskheta districts with total population of about 70.000. All subjects provided information on asthma, bronchitis, respiratory symptoms, smoking, allergic conditions, CRD comorbidity and lifestyle via an interviewer-administered questionnaire. A total of 3,646 questionnaires were analysed. Results. It was discovered that official data concerning allergic rhinitis, TB and asthma are almost equal, but readings in relation to CRD are about five times lower according to official data of the Ministry of Health of Georgia. The data results: for allergic rhinitis - 218 in GAPS vs. 177 in the official statistics (for 100.000 population); for TB -105 in GAPS vs. 147 in the official statistics; for asthma -250 in GAPS vs. 374 in the official statistics; the data about CRD according to our survey is almost five times higher - 365 in GAPS vs. 84 in the official statistics (for 100.000 population). Conclusions. It is necessary to expand the survey to the entire country population. Country results are likely to be useful and interesting for local doctors and managers, as well as for officials.

scholarly journals Rigorous development of computer based Integrated Care Pathways for HIV patients

2014 ◽  
Author(s):  
Petros Papapanagiotou ◽  
Jacques Fleuriot ◽  
Areti Manataki ◽  
Andrew Winter ◽  
Rak Nandwani ◽  
...  
Keyword(s):  
Integrated Care ◽  
Care Pathways ◽  
Hiv Patients ◽  
Integrated Care Pathways ◽  
Computer Based
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