Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases

In all societies, the burden and cost of allergic and chronic respiratory diseasesare increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated carewith organizational health literacy. As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, 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, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealthto monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacyand self-care through technology-assisted “patient activation”, (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global politicalagendas are of great importance in supporting the digital transformationof health and care, and MASK has been recognized by DG Sante as a Good Practice in the field of digitally-enabled, integrated, person-centred care. In 20 years, ARIA has considerably evolved from the first multimorbidityguideline in respiratory diseasesto the digital transformationof health and care with a strong political involvement.