Di Fraia Marco, Tripodi Salvatore, Arasi Stefania, Dramburg Stephanie, Castelli Sveva, Villalta Danilo, Buzzulini Francesca, Sfika Ifigenia, Villella Valeria, Potapova Ekaterina, Perna Serena, Brighetti Maria Antonia, Travaglini Alessandro, Verardo Pierluigi, Pelosi Simone, Zicari Anna Maria, Matricardi Paolo Maria
Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité University Medicine, Berlin, Germany.
Department of Pediatrics, Sapienza University of Rome, Rome, Italy.
J Med Internet Res. 2020 Mar 16;22(3):e16642. doi: 10.2196/16642.
Complete diagnosis and therapy of seasonal allergic rhinoconjunctivitis require evidence that exposure to the sensitizing pollen triggers allergic symptoms. Electronic clinical diaries, by recording disease severity scores and pollen exposure, can demonstrate this association. However, patients who spontaneously download an e-diary app show very low adherence to their recording.
The objective of our study was to assess adherence of patients with seasonal allergic rhinitis to symptom recording via e-diary explicitly prescribed by an allergist within a blended care approach.
The @IT-2020 project is investigating the diagnostic synergy of mobile health and molecular allergology in patients with seasonal allergic rhinitis. In the pilot phase of the study, we recruited Italian children (Rome, Italy) and adults (Pordenone, Italy) with seasonal allergic rhinitis and instructed them to record their symptoms, medication intake, and general conditions daily through a mobile app (Allergy.Monitor) during the relevant pollen season.
Overall, we recruited 101 Italian children (Rome) and 93 adults (Pordenone) with seasonal allergic rhinitis. Adherence to device use slowly declined during monitoring in 3 phases: phase A: first week, ≥1267/1358, 90%; phase B: second to sixth week, 4992/5884, 80% to 90%; and phase C: seventh week onward, 2063/2606, 70% to 80%. At the individual level, the adherence assessed in the second and third weeks of recording predicted with enough confidence (Rome: Spearman ρ=0.75; P<.001; Pordenone: ρ=0.81; P<.001) the overall patient adherence to recording and was inversely related to postponed reporting (ρ=-0.55; P<.001; in both centers). Recording adherence was significantly higher during the peak grass pollen season in Rome, but not in Pordenone.
Adherence to daily recording in an e-diary, prescribed and motivated by an allergist in a blended care setting, was very high. This observation supports the use of e-diaries in addition to face-to-face visits for diagnosis and treatment of seasonal allergic rhinitis and deserves further investigation in real-life contexts.
季节性变应性鼻结膜炎的完整诊断和治疗需要有证据表明接触致敏花粉会引发过敏症状。电子临床日记通过记录疾病严重程度评分和花粉暴露情况，可以证明这种关联。然而，自发下载电子日记应用程序的患者对记录的依从性非常低。
我们研究的目的是评估在混合护理模式下，由过敏症专科医生明确规定使用电子日记记录症状的季节性变应性鼻炎患者的依从性。
@IT - 2020项目正在研究移动健康与分子变应性学在季节性变应性鼻炎患者中的诊断协同作用。在研究的试点阶段，我们招募了患有季节性变应性鼻炎的意大利儿童（意大利罗马）和成人（意大利波代诺内），并指示他们在相关花粉季节通过移动应用程序（Allergy.Monitor）每天记录症状、药物摄入情况和一般状况。
总体而言，我们招募了101名患有季节性变应性鼻炎的意大利儿童（罗马）和93名成人（波代诺内）。在监测的三个阶段中，设备使用的依从性逐渐下降：A阶段：第一周，≥1267/1358，90%；B阶段：第二至六周，4992/5884，80%至90%；C阶段：第七周及以后，2063/2606，70%至80%。在个体层面，记录第二周和第三周评估的依从性有足够信心预测（罗马：Spearman ρ = 0.75；P <.001；波代诺内：ρ = 0.81；P <.001）患者总体记录依从性，且与延迟报告呈负相关（ρ = -0.55；P <.001；在两个中心均如此）。罗马的禾本科花粉高峰期记录依从性显著更高，但波代诺内并非如此。
在混合护理环境中，由过敏症专科医生规定并激励使用的电子日记，其每日记录的依从性非常高。这一观察结果支持在季节性变应性鼻炎的诊断和治疗中，除面对面就诊外还使用电子日记，且值得在现实环境中进一步研究。
