Проект “Aria”: Шляхи Надання Медичної Допомоги При Алергічному Риніті (2019 Рік) – Україна

Abstract

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.