{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T05:10:44Z","timestamp":1768626644870,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,3,17]],"date-time":"2022-03-17T00:00:00Z","timestamp":1647475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Co\u2010medication is common among patients with allergic rhinitis (AR), but its dimension and patterns are unknown. This is particularly relevant since AR is understood differently across European countries, as reflected by rhinitis\u2010related search patterns in Google Trends. This study aims to assess AR co\u2010medication and its regional patterns in Europe, using real\u2010world data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed 2015\u20132020\u00a0MASK\u2010air<jats:sup>\u00ae<\/jats:sup> European data. We compared days under no medication, monotherapy and co\u2010medication using the visual analogue scale (VAS) levels for overall allergic symptoms (\u2018VAS Global Symptoms\u2019) and impact of AR on work. We assessed the monthly use of different medication schemes, performing separate analyses by region (defined geographically or by Google Trends patterns). We estimated the average number of different drugs reported <jats:italic>per<\/jats:italic> patient within 1\u00a0year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analysed 222,024\u00a0days (13,122 users), including 63,887\u00a0days (28.8%) under monotherapy and 38,315 (17.3%) under co\u2010medication. The median \u2018VAS Global Symptoms\u2019 was 7 for no medication days, 14 for monotherapy and 21 for co\u2010medication (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Medication use peaked during the spring, with similar patterns across different European regions (defined geographically or by Google Trends). Oral H<jats:sub>1<\/jats:sub>\u2010antihistamines were the most common medication in single and co\u2010medication. Each patient reported using an annual average of 2.7 drugs, with 80% reporting two or more.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Allergic rhinitis medication patterns are similar across European regions. One third of treatment days involved co\u2010medication. These findings suggest that patients treat themselves according to their symptoms (irrespective of how they understand AR) and that co\u2010medication use is driven by symptom severity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.15275","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T11:29:56Z","timestamp":1646738996000},"page":"2699-2711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Behavioural patterns in allergic rhinitis medication in Europe: A study using MASK\u2010air<sup>\u00ae<\/sup> real\u2010world data"],"prefix":"10.1111","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1277-3401","authenticated-orcid":false,"given":"Bernardo","family":"Sousa\u2010Pinto","sequence":"first","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto  Porto Portugal"},{"name":"CINTESIS \u2013 Center for Health Technology and Services Research University of Porto  Porto Portugal"},{"name":"RISE \u2013 Health Research Network; University of Porto  Porto Portugal"}]},{"given":"Ana","family":"S\u00e1\u2010Sousa","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto  Porto Portugal"},{"name":"CINTESIS \u2013 Center for Health Technology and Services Research University of Porto  Porto Portugal"},{"name":"RISE \u2013 Health Research Network; University of Porto  Porto Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1834-3055","authenticated-orcid":false,"given":"Rafael Jos\u00e9","family":"Vieira","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto  Porto Portugal"},{"name":"CINTESIS \u2013 Center for Health Technology and Services Research University of Porto  Porto Portugal"},{"name":"RISE \u2013 Health Research Network; University of Porto  Porto Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0233-830X","authenticated-orcid":false,"given":"Rita","family":"Amaral","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto  Porto Portugal"},{"name":"CINTESIS \u2013 Center for Health Technology and Services Research University of Porto  Porto Portugal"},{"name":"RISE \u2013 Health Research Network; University of Porto  Porto Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2455-0192","authenticated-orcid":false,"given":"Ludger","family":"Klimek","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Universit\u00e4tsmedizin Mainz  Mainz Germany"},{"name":"Center for Rhinology and Allergology  Wiesbaden Germany"}]},{"given":"Wienczyslawa","family":"Czarlewski","sequence":"additional","affiliation":[{"name":"Medical Consulting Czarlewski  Levallois France"},{"name":"MASK\u2010air  Montpellier France"}]},{"given":"Josep M.","family":"Ant\u00f3","sequence":"additional","affiliation":[{"name":"ISGlobal, Barcelona Institute for Global Health  Barcelona Spain"},{"name":"IMIM (Hospital del Mar Medical Research Institute)  Barcelona Spain"},{"name":"Universitat Pompeu Fabra (UPF)  Barcelona Spain"},{"name":"CIBER Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP)  Barcelona Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4374-9639","authenticated-orcid":false,"given":"Oliver","family":"Pfaar","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy University Hospital Marburg, Philipps\u2010Universit\u00e4t Marburg  Marburg Germany"}]},{"given":"Anna","family":"Bedbrook","sequence":"additional","affiliation":[{"name":"MASK\u2010air  Montpellier France"}]},{"given":"Violeta","family":"Kvedariene","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine Vilnius University and Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University  Vilnius Lithuania"}]},{"given":"Maria Teresa","family":"Ventura","sequence":"additional","affiliation":[{"name":"University of Bari Medical School, Unit of Geriatric Immunoallergology  Bari Italy"}]},{"given":"Ignacio J.","family":"Ansotegui","sequence":"additional","affiliation":[{"name":"Department of Allergy and Immunology Hospital Quironsalud Bizkaia  Bilbao Spain"}]},{"given":"Karl\u2010Christian","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Institute of Allergology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin Corporate Member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology  Berlin Germany"}]},{"given":"Luisa","family":"Brussino","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Allergy and Clinical Immunology Unit University of Torino &amp; Mauriziano Hospital  Torino Italy"}]},{"given":"G. Walter","family":"Canonica","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University  Pieve Emanuele Italy"},{"name":"Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS  Rozzano Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2197-9767","authenticated-orcid":false,"given":"Victoria","family":"Cardona","sequence":"additional","affiliation":[{"name":"Allergy Section, Department of Internal Medicine Hospital Vall d'Hebron &amp; ARADyAL Research Network  Barcelona Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4129-133X","authenticated-orcid":false,"given":"Pedro","family":"Carreiro\u2010Martins","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Imunoalergologia, Hospital de Dona Estef\u00e2nia Centro Hospitalar Universit\u00e1rio de Lisboa Central  Lisbon Portugal"},{"name":"NOVA Medical School\/Comprehensive Health Research Center (CHRC)  Lisbon Portugal"}]},{"given":"Tomas","family":"Casale","sequence":"additional","affiliation":[{"name":"Division of Allergy\/Immunology University of South Florida  Tampa Florida USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0658-2449","authenticated-orcid":false,"given":"Lorenzo","family":"Cecchi","sequence":"additional","affiliation":[{"name":"SOS Allergology and Clinical Immunology USL Toscana Centro  Prato Italy"}]},{"given":"Tom\u00e1s","family":"Chivato","sequence":"additional","affiliation":[{"name":"School of Medicine University CEU San Pablo  Madrid Spain"}]},{"given":"Derek K.","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Medicine and Health Research Methods, Evidence &amp; 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