Daily allergic multimorbidity in rhinitis using mobile technology: A novel concept of the MASK study.

BACKGROUND: Multimorbidity in allergic airway diseases is well known, but no data exist about the daily dynamics of symptoms and their impact on work. To better understand this, we aimed to assess the presence and control of daily allergic multimorbidity (asthma, conjunctivitis, rhinitis) and its impact on work productivity using a mobile technology, the Allergy Diary. METHODS: We undertook a 1-year prospective observational study in which 4 210 users and 32 585 days were monitored in 19 countries. Five visual analogue scales (VAS) assessed the daily burden of the disease (i.e., global evaluation, nose, eyes, asthma and work). Visual analogue scale levels <20/100 were categorized as "Low" burden and VAS levels ≥50/100 as "High" burden. RESULTS: Visual analogue scales global measured levels assessing the global control of the allergic disease were significantly associated with allergic multimorbidity. Eight hypothesis-driven patterns were defined based on "Low" and "High" VAS levels. There were <0.2% days of Rhinitis Low and Asthma High or Conjunctivitis High patterns. There were 5.9% days with a Rhinitis High-Asthma Low pattern. There were 1.7% days with a Rhinitis High-Asthma High-Conjunctivitis Low pattern. A novel Rhinitis High-Asthma High-Conjunctivitis High pattern was identified in 2.9% days and had the greatest impact on uncontrolled VAS global measured and impaired work productivity. Work productivity was significantly correlated with VAS global measured levels. CONCLUSIONS: In a novel approach examining daily symptoms with mobile technology, we found considerable intra-individual variability of allergic multimorbidity including a previously unrecognized extreme pattern of uncontrolled multimorbidity.

Prevalence of ankylosing spondylitis in Poland and costs generated by AS patients in the public healthcare system.

The aim of the research was to analyse the prevalence of ankylosing spondylitis (AS) in Poland and to assess the costs generated by AS patients in the system of public health care. The database of national payer-National Health Fund (NHF)-has been analysed. For the analysis, the information has been extracted from IT system about each treated patient with ICD-10 = M45 code as main or coexisting diagnosis included in the mandatory reports from entities of public healthcare service. In the years 2008-2013, from 28,800 to 32,800 persons diagnosed with AS as main or coexisting diagnosis have been registered in NHF database. In 2013, the prevalence amounted to 7.48 for 10,000 persons of general population-the highest in Kujawy-Pomerania province (10.92 per 10,000 inhabitants), Silesia (10.04) and Swietokrzyskie province (9.81). In male patients, this coefficient amounted to 8.91 per 10,000 inhabitants, whereas in female-to 6.15. In 2013, the prevalence for men was the highest in the age group of 60-64 years and for women in the group of 65-69 years. The healthcare expenses related to AS financed by the NHF increased from 13,200 million PLN (6.3 million USD) in 2008 to 72,600 million PLN (21,900 million USD) in 2013. The increase in healthcare expenses related to AS patients in the public healthcare system is significant and noticeable. High regional diversity is also a vital issue. It is necessary to carry out further research on the incidence rate of AS in Polish population.

Prevention and control of childhood asthma and allergy in the EU from the public health point of view: Polish Presidency of the European Union.

The leading priority for the Polish Presidency of the Council of the European Union was to reduce health inequalities across European societies, and, within its framework, prevention and control of respiratory diseases in children. This very important paper contain proposal of international cooperation on the prevention, early detection and monitoring of asthma and allergic diseases in childhood which will be undertaken by the EU member countries as a result of EU conclusion developed during the Polish Presidency of the Council of the European Union. This will result in collaboration in the field of chronic diseases, particularly respiratory diseases, together with the activity of the network of national institutions and NGOs in this area. Paper also contains extensive analysis of the socio-economic, political, epidemiological, technological and medical factors affecting the prevention and control of childhood asthma and allergy presented during Experts presidential conference organized in Warsaw-Ossa 21-22 September 2011.