MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis

Bousquet, Jean; Schã¼nemann, Holger J.; Hellings, Peter W.; Arnavielhe, Sylvie; Bachert, Claus; Bedbrook, Anna; Bergmann, Karl-Christian; Bosnic-Anticevich, Sinthia; Brozek, Jan; Calderon, Moises; Canonica, G. Walter; Casale, Thomas B.; Chavannes, Niels H.; Cox, Linda; Chrystyn, Henry; Cruz, Alvaro A.; Dahl, Ronald; De Carlo, Giuseppe; Demoly, Pascal; Devillier, Phillipe; Dray, Gã©rard; Fletcher, Monica; Fokkens, Wytske J.; Fonseca, Joao; Gonzalez-Diaz, Sandra N.; Grouse, Lawrence; Keil, Thomas; Kuna, Piotr; Larenas-Linnemann, Dã©sirã©e; Lodrup Carlsen, Karin C.; Meltzer, Eli O.; Mullol, Jaoquim; Muraro, Antonella; Naclerio, Robert N.; Palkonen, Susanna; Papadopoulos, Nikolaos G.; Passalacqua, Giovanni; Price, David; Ryan, Dermot; Samolinski, Boleslaw; Scadding, Glenis K.; Sheikh, Aziz; Spertini, Franã§ois; Valiulis, Arunas; Valovirta, Erkka; Walker, Samantha; Wickman, Magnus; Yorgancioglu, Arzu; Haahtela, Tari; Zuberbier, Torsten; Aberer, Werner; Adachi, Mitsuru; Agache, Ioana; Akdis, Cezmi; Akdis, Mubeccel; Annesi-Maesano, Isabella; Ansotegui, Ignacio J.; Anto, Josep M.; Arshad, S. Hasan; Baiardini, Ilaria; Baigenzhin, Abay K.; Barbara, Cristina; Bateman, Eric D.; Beghã©, Bianca; Bel, Elisabeth H.; Ben Kheder, Ali; Bennoor, Kazi S.; Benson, Michael; Bernstein, David; Michael, Bewick; Thomas, Bieber; Bindslev-Jensen, Carsten; Bjermer, Leif; Blain, Hubert; Boner, Attilio; Bonini, Matteo; Bonini, Sergio; Bosse, Isabelle; Bouchard, Jacques; Boulet, Louis-Philippe; Bourret, Rodolphe A.; Bousquet, Philippe J.; Braido, Fulvio; Briggs, Andrew H.; Brightling, Christopher E.; Buhl, Roland; Burney, Peter; Bush, Andrew; Caballero-Fonseca, Fernando; Caimmi, Davide P.; Camargos, Paulo; Camuzat, Thierry; Carlsen, Kai-Hakon; Carr, Warner; Casale, Thomas B.; Sarabia, Alfonso Cepeda; Chatzi, Leda; Chen, Yuzhi; Chiron, Raphaã«l; Chkhartishvili, Ekaterine; Chuchalin, Alexander; Ciprandi, Georgio; Cirule, Ieva; Correia de Sousa, Jaime; Costa, David; Crooks, George; Custovic, Adnan; Dahlen, Sven-Erik; Darsow, Ulf; De Blay, Frã©dã©ric; De Manuel Keenoy, Esteban; Dedeu, Tony; Deleanu, Diana; Denburg, Judah; Didier, Alain; Dinh-Xuan, Anh-Tuan; Dokic, Dejan; Douagui, Habib B.; Dubakiene, Ruta; Durham, Stephen; Dykewicz, Mark; El-Gamal, Yehia; Emuzyte, Regina; Fink-Wagner, Antje; Fiocchi, Alessandro; Forastiere, Francesco; Gamkrelidze, Amiran; Gemicioäÿlu, Bilun; Gereda, Jose E.; Gerth van Wijk, Roy; Gotua, Maia; Grisle, Ineta; Guzmã¡n, M. Antonieta; Haahtela, Tari; Heinrich, Joachim; Hellquist-Dahl, Birthe; Horak, Friedrich; Howarth, Peter H.; Humbert, Marc; Hyland, Michael; Ivancevich, Juan-Carlos; Jares, Edgardo J.; Johnston, Sebastian L.; Jonquet, Olivier; Joos, Guy; Jung, Ki-Suck; Just, Jocelyne; Jutel, Marek; Kaidashev, Igor P.; Khaitov, Musa; Kalayci, Omer; Kalyoncu, Fuat; Keith, Paul; Khaltaev, Nikolai; Kleine-Tebbe, Jorg; Klimek, Ludger; N'Goran, Bernard Koffi; Kolek, Vitezlav; Koppelman, Gerard H.; Kowalski, Marek; Kull, Inger; Kvedariene, Violeta; Lambrecht, Bart; Lau, Susanne; Laune, Daniel; Le Thi Tuyet, Lan; Jing, Li; Lieberman, Phillipe; Lipworth, Brian J.; Renaud, Louis; Magard, Yves; Magnan, Antoine; Mahboub, Bassam; Majer, Ivan; Makela, Mika; Manning, Peter J.; Masjedi, Mohamad R.; Maurer, Marcus; Mavale-Manuel, Sandra; Melã©n, Erik; Melo-Gomes, Elisabete; Mercier, Jacques; Merk, Hans; Miculinic, Neven; Mihaltan, Florin; Milenkovic, Branislava; Mohammad, Yousser; Molimard, Mathieu; Momas, Isabelle; Montilla-Santana, Anna; Morais-Almeida, Mario; Mã¶sges, Ralph; Nadif, Rachel; Namazova-Baranova, Leyla; Neffen, Hugo; Nekam, Kristof; Neou, Angelos; Niggemann, Bodo; Nyembue, Dieudonnã©; O'Hehir, Robyn; Ohta, Ken; Okamoto, Yoshitaka; Okubo, Kim; Ouedraogo, Solange; Paggiaro, Pier-Luigi; Pali-SchÃ¶ll, Isabella; Palmer, Stephen; Panzner, Petr; Papi, Alberto; Park, Hae-Sim; Pavord, Ian; Pawankar, Ruby; Pfaar, Oliver; Picard, Robert; Pigearias, Bernard; Pin, Isabelle; Plavec, Davor; Pohl, Wolfgang; Popov, Todor; Postma, Dirkje S.; Potter, Paul; Poulsen, Lars K.; Rabe, Klaus F.; Raciborski, Filip; Pontal, FranÃ§oise Radier; Reitamo, Sakari; Repka-Ramirez, Maria-Susana; Robalo-Cordeiro, Carlos; Roberts, Graham; Rodenas, Francisco; Rolland, Christine; Rodriguez, Miguel Roman; Romano, Antonino; Rosado-Pinto, Josã©; Rosario, Nelson A.; Rosenwasser, Larry; Rottem, Menachem; Sanchez-Borges, Mario; Sastre-Dominguez, Joaquim; Schmid-Grendelmeier, Peter; Serrano, Eli; Simons, F. Estelle R.; Sisul, Juan-Carlos; Skrindo, Ingebjorg; Smit, Henriette A.; Solã©, Dirceu; Sooronbaev, Talant; Spranger, Otto; Stelmach, Rafael; Strandberg, Timo; Sunyer, Jordi; Thijs, Carel; Todo-Bom, Ana-Maria; Triggiani, Massimo; Valenta, Rudolf; Valero, Antonio L.; van Hage, Marianne; Vandenplas, Olivier; Vezzani, Giorgio; Vichyanond, Pakit; Viegi, Giovanni; Wagenmann, Martin; Wahn, Ulrich; De Yun, Wang; Williams, Denis; Wright, John; Yawn, Barbara P.; Yiallouros, Panayiotis; Yusuf, Osman M.; Zar, Heather J.; Zernotti, Mario; Zhang, Luo; Zhong, Nanshan; Zidarn, Mihaela

doi:10.1016/j.jaci.2016.03.025

The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control. Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). AÂ CDSS is currently being developed to optimize AR control. An algorithm developed by consensus is presented in this article. This algorithm should be confirmed by appropriate trials.