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- Adherence to treatment in allergic rhinitis during the pollen season in Europe: A MASK‐air StudyPublication . Bousquet, Jean; Amaral, RitaAdherence to rhinitis treatment has been insufficiently assessed. We aimed to use data from the MASK-airmHealth app to assess adherence to oral antihistamines (OAH), intra-nasal corticosteroids (INCS) or azelastine-fluticasone inpatients with allergic rhinitis. We included regular European MASK-air users with self-reported allergic rhinitis and reporting at least 1 day of OAH,INCS or azelastine-fluticasone. We assessed weeks during which patients answered the MASK-air questionnaire on all days. Werestricted our analyses to data provided between January and June, to encompass the pollen seasons across the different assessedcountries. We analysed symptoms using visual analogue scales (VASs) and the combined symptom-medication score (CSMS),performing stratified analyses by weekly adherence levels. Medication adherence was computed as the proportion of days inwhich patients reported rhinitis medication use. Sensitivity analyses were performed considering all weeks with at most 1 day ofmissing data and all months with at most 4 days of missing data. We assessed 8212 complete weeks (1361 users). Adherence (use of medication > 80% days) to specific drug classesranged from 31.7% weeks for azelastine-fluticasone to 38.5% weeks for OAH. Similar adherence to rhinitis medication was foundin users with or without self-reported asthma, except for INCS (better adherence in asthma patients). VAS and CSMS levelsincreased from no adherence to full adherence, except for INCS. A higher proportion of days with uncontrolled symptoms was observed in weeks with higher adherence. In full adherence weeks, 41.2% days reported rhinitis co-medication. The sensitivityanalyses displayed similar results. A high adherence was found in patients reporting regular use of MASK-air. Different adherence patterns werefound for INCS compared to OAH or azelastine-fluticasone that are likely to impact guidelines.
- Control of allergic rhinitis and asthma test for children (CARATkids): A systematic review and meta-analysis of its measurement propertiesPublication . Didi, Hadla Sami El; Pereira, Ana Margarida; Jácome, Cristina; Amaral, Rita; Wandalsen, Gustavo F.; Emons, Joyce; Grutta, Stefania La; Cilluffo, Giovanna; Batmaz, Sehra Birgül; Linhares, Daniela; Sole, Dirceu; Pinto, Bernardo Sousa; Fonseca, João Almeida; Vieira, Rafael José; Amaral, RitaControl of Allergic Rhinitis and Asthma Test for Children (CARATkids) is the first patient-reported outcome measure (PROM) designed to assess both allergic rhinitis and asthma simultaneously in children aged 6 to 12 years. CARATkids has been validated in several languages and countries, highlighting the need for a review of its psychometric properties. This study aims to evaluate the measurement properties of CARATkids. This systematic review follows PRISMA and COSMIN guidelines. A systematic search was performed across three databases (Ovid/MEDLINE, Web of Science, and Scopus in October 2023, updated in June 2025). We included studies focused on the development, cultural adaptation, or validation of CARATkids, as well as studies comparing CARATkids with other PROMs. We evaluated the quality of CARATkids development, the methodological quality of primary studies, the overall rating, and the certainty of evidence for each CARATkids measurement property and performed a meta-analysis of its measurement properties. Our search retrieved 193 results. We included nine studies. CARATkids displayed sufficient content validity. Regarding internal consistency, we found a meta-analytical Cronbach alpha of 0.81 (95% CI = 0.79; 0.83). CARATkids displayed sufficient reliability (meta-analytical intraclass correlation coefficient 0.86 [95% CI = 0.61; 0.96]). The minimal clinically important difference was 2.76. Construct validity had sufficient evidence for most correlations, with absolute meta-analytical Spearman coefficients from 0.37 to 0.71. Responsiveness showed strong correlations between CARATkids and most outcome measurement instruments. These findings support CARATkids as a suitable tool for assessing asthma and allergic rhinitis in children aged 6 to 12 years who present both conditions simultaneously.