Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Enrica Menditto, Elisio Costa, Luis Midão, Sinthia Bosnic-Anticevich, Ettore Novellino, Slawomir Bialek, Vitalis Briedis, Alpana Mair, Rojin Rajabian-Soderlund, Sylvie Arnavielhe, Anna Bedbrook, Wienczyslawa Czarlewski, Isabella Annesi-Maesano, Josep M. Anto, Philippe Devillier, Govert De Vries, Thomas Keil, Aziz Sheikh, Valentina Orlando, Désirée Larenas-LinnemannLorenzo Cecchi, Giulia De Feo, M. Illario, Cristiana Stellato, Joao Fonseca, Joao Malva, Mario Morais-Almeida, Ana Maria Pereira, Ana Maria Todo-Bom, Violeta Kvedariene, Arunas Valiulis, Karl Christian Bergmann, Ludger Klimek, Ralph Mösges, Oliver Pfaar, Torsten Zuberbier, Vicky Cardona, Joaquim Mullol, Nikos G. Papadopoulos, Emmanuel P. Prokopakis, Mike Bewick, Dermot Ryan, Regina E. Roller-Wirnsberger, Peter Valentin Tomazic, Alvaro A. Cruz, Piotr Kuna, Boleslaw Samolinski, Wytske J. Fokkens, Sietze Reitsma, Isabelle Bosse, Jean François Fontaine, Daniel Laune, Tari Haahtela, Sanna Toppila-Salmi, Claus Bachert, Peter W. Hellings, Erik Melén, Magnus Wickman, Carsten Bindslev-Jensen, Esben Eller, Robyn E. O'Hehir, Cemal Cingi, Bilun Gemicioğlu, Omer Kalayci, Juan Carlos Ivancevich, Jean Bousquet, the MASK group

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68 Citations (Scopus)


Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries. Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App. Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach. Results: A total of 12 143 users were registered. A total of 6 949 users reported at least one VAS data recording. Among them, 1 887 users reported ≥7 VAS data. About 1 195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR ≥70% and PDC ≤1.25), 51 (4.23%) were partly adherent (MPR ≥70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR <70%). Of those, the largest group was non-adherent to medications and the time interval was increased in 442 (36.68%) users. Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting.

Original languageEnglish
Pages (from-to)442-460
Number of pages19
JournalClinical and Experimental Allergy
Issue number4
Publication statusPublished - Apr 2019


  • adherence
  • mHealth
  • mobile technology
  • observational study
  • rhinitis
  • treatment

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