Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study

Clin Exp Allergy. 2019 Apr;49(4):442-460. doi: 10.1111/cea.13333. Epub 2019 Mar 12.


Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries.

Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App.

Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach.

Results: A total of 12 143 users were registered. A total of 6 949 users reported at least one VAS data recording. Among them, 1 887 users reported ≥7 VAS data. About 1 195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR ≥70% and PDC ≤1.25), 51 (4.23%) were partly adherent (MPR ≥70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR <70%). Of those, the largest group was non-adherent to medications and the time interval was increased in 442 (36.68%) users.

Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting.

Keywords: adherence; mHealth; mobile technology; observational study; rhinitis; treatment.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Cell Phone Use*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Medical Records
  • Medication Adherence*
  • Middle Aged
  • Mobile Applications*
  • Patient Outcome Assessment
  • Rhinitis, Allergic / diagnosis
  • Rhinitis, Allergic / epidemiology*
  • Rhinitis, Allergic / therapy
  • Surveys and Questionnaires