University of Bari Medical School, Unit of Geriatric Immunoallergology, Bari, Italy.
Dermatology Section, IRCCS Istituto Oncologico Giovanni Paolo II, Bari, Italy.
Int Arch Allergy Immunol. 2022;183(11):1178-1188. doi: 10.1159/000525595. Epub 2022 Sep 6.
Allergic rhinitis (AR) is a disease characterized by IgE-mediated hypersensitivity responses akin to allergic asthma. Although common in children and young adults, AR can be particularly vexing in the elderly: several studies have underlined its impact on the patient's self-perceived health-related quality of life (HR-QoL). Available literature data on AR-affected elderly patients remain sparse and often focused on specific characteristics. mHealth solutions such as MASK-air® can be used in assessing salient clinical characteristics and unique shifts in self-perceived HR-QoL in old age people. With this pilot study, we aim to assess these variables in two cohorts of AR-affected elderly patients - one actively involved in the daily use of mHealth applications and the other having never used such a solution - by applying a widespread, validated, and standardized tool.
AR-affected patients aged ≥65 years accessing the outpatient clinic of the Bari Geriatric Immuno-allergology Unit between March and July 2021 were enrolled and assigned to "mHealth" (MASK-air®) and "non-mHealth" cohorts accordingly. Each participant was given a 19-item questionnaire delivered via a custom software solution, with the EuroQoL EQ-5D-5L used to assess HR-QoL.
93 patients (51 mHealth users, 43 non-mHealth users) were enrolled. AR was often either standalone or associated with asthma and conjunctivitis, and 57.4% of the participants reported a negative influence of AR on daily activities. Analysis of HR-QoL showed significantly worse scores in mobility and anxiety/depression dimensions for female patients regardless of app usage, while male non-mHealth users had worse self-care scores. Female mHealth users had worse scores for the self-care and activity dimensions, whereas female non-mHealth users showed worse scores on the pain scale. In general, mHealth users showed a greater degree of anxiety/depression when compared to non-mHealth users, relating to a greater awareness of their health status.
The use of an mHealth solution, along with a concise, clinically-validated, comprehensive HR-QoL assessment toolset such as the EQ-5D, can prove beneficial in defining the unique characteristics of AR in the elderly. It can enable a detailed exploration of the impact on specific aspects of quality of life in old age. Raising patient awareness towards a health condition can improve compliance to treatment as well as follow-up. A lack of uniformity in approach, along with missing data pertaining to the general population are critical issues that require further studies. A more thorough diffusion of mHealth usage is also necessary among the geriatric population.
过敏性鼻炎（AR）是一种以 IgE 介导的过敏反应为特征的疾病，类似于过敏性哮喘。尽管在儿童和年轻人中很常见，但 AR 在老年人中可能特别麻烦：几项研究强调了它对患者自我感知健康相关生活质量（HR-QoL）的影响。关于受 AR 影响的老年患者的可用文献数据仍然很少，并且通常侧重于特定特征。移动健康（mHealth）解决方案，如 MASK-air®，可用于评估老年人的重要临床特征和自我感知 HR-QoL 的独特变化。通过这项初步研究，我们旨在通过应用广泛、经过验证和标准化的工具，评估两组受 AR 影响的老年患者的这些变量——一组积极参与日常使用 mHealth 应用，另一组从未使用过此类解决方案。
2021 年 3 月至 7 月期间，在巴里老年免疫过敏学系门诊就诊的年龄≥65 岁的 AR 患者被纳入并按“mHealth”（MASK-air®）和“非 mHealth”队列进行分组。每个参与者都收到了一份通过定制软件解决方案提供的 19 项问卷，使用 EuroQoL EQ-5D-5L 评估 HR-QoL。
共有 93 名患者（51 名 mHealth 用户，43 名非 mHealth 用户）入组。AR 通常是单独存在的，也可能与哮喘和结膜炎有关，57.4%的患者报告 AR 对日常活动有负面影响。对 HR-QoL 的分析显示，无论使用应用程序与否，女性患者在移动性和焦虑/抑郁维度上的评分都明显较差，而男性非 mHealth 用户的自我护理评分较差。女性 mHealth 用户在自我护理和活动维度上的评分较差，而女性非 mHealth 用户在疼痛量表上的评分较差。一般来说，与非 mHealth 用户相比，mHealth 用户的焦虑/抑郁程度更高，这与他们对自身健康状况的认识程度更高有关。
使用 mHealth 解决方案以及简明、临床验证、全面的 HR-QoL 评估工具包（如 EQ-5D）可以证明对确定老年人 AR 的独特特征有益。它可以详细探索对老年特定生活质量方面的影响。提高患者对健康状况的认识可以提高治疗和随访的依从性。方法缺乏一致性以及与一般人群相关的数据缺失是需要进一步研究的关键问题。还需要在老年人群中更广泛地推广 mHealth 的使用。
