Academic Productivity of Young People With Allergic Rhinitis: A MASK-air Study
Rafael José Vieira 1, Nhân Pham-Thi 2, Josep M Anto 3, Wienczyslawa Czarlewski 4, Ana Sá-Sousa 1, Rita Amaral 1, Anna Bedbrook 5, Sinthia Bosnic-Anticevich 6, Luisa Brussino 7, G Walter Canonica 8, Lorenzo Cecchi 9, Alvaro A Cruz 10, Wytske J Fokkens 11, Bilun Gemicioglu 12, Tari Haahtela 13, Juan Carlos Ivancevich 14, Ludger Klimek 15, Piotr Kuna 16, Violeta Kvedariene 17, Désirée Larenas-Linnemann 18, Mario Morais-Almeida 19, Joaquim Mullol 20, Marek Niedoszytko 21, Yoshitaka Okamoto 22, Nikolaos G Papadopoulos 23, Vincenzo Patella 24, Oliver Pfaar 25, Frederico S Regateiro 26, Sietze Reitsma 11, Philip W Rouadi 27, Boleslaw Samolinski 28, Aziz Sheikh 29, Luis Taborda-Barata 30, Sanna Toppila-Salmi 13, Joaquin Sastre 31, Ioanna Tsiligianni 32, Arunas Valiulis 33, Maria Teresa Ventura 34, Susan Waserman 35, Arzu Yorgancioglu 36, Mihaela Zidarn 37, Torsten Zuberbier 38, João A Fonseca 1, Jean Bousquet 39, Bernardo Sousa-Pinto 1; MASK study group
Affiliations
Affiliations
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS-Center for Health Technology and Services Research, University of Porto, Porto, Portugal; RISE-Health Research Network, University of Porto, Porto, Portugal.
- Ecole Polytechnique Palaiseau, IRBA (Institut de Recherche bio-Médicale des Armées), Bretigny, France.
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
- Medical Consulting Czarlewski, Levallois, France.
- ARIA, Montpellier, France.
- Quality Use of Respiratory Medicine Group, Woolcock Institute of Medical Research, the University of Sydney, Sydney, NSW, Australia; Sydney Local Health District, Sydney, NSW, Australia.
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy.
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy.
- SOS Allergology and Clinical Immunology, USL Toscana Centro, Prato, Italy.
- Fundaçao ProAR, Federal University of Bahia and GARD/WHO Planning Group, Salvador, Bahia, Brazil.
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, AMC, Amsterdam, the Netherlands.
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
- Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina.
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany; Center for Rhinology and Allergology, Wiesbaden, Germany.
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland.
- Institute of Biomedical Sciences, Department of Pathology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Institute of Clinical Medicine, Clinic of Chest Diseases and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
- Center of Excellence in Asthma and Allergy, Médica Sur Clinical Foundation and Hospital, México City, Mexico.
- Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.
- Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic, Barcelona, Spain; Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain; CIBERES, University of Barcelona, Barcelona, Spain.
- Department of Allergology, Medical University of Gdańsk, Gdansk, Poland.
- Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan.
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.
- Division of Allergy and Clinical Immunology, Department of Medicine, Agency of Health ASL Salerno, "Santa Maria della Speranza" Hospital, Battipaglia, Salerno, Italy.
- Department of Otorhinolaryngology, Head and Neck Surgery, Section of Rhinology and Allergy, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
- Allergy and Clinical Immunology Unit, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Institute of Immunology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon; ENT Department, Dar Al Shifa Hospital, Salmiya, Kuwait.
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland.
- Usher Institute, the University of Edinburgh, Edinburgh, UK.
- Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; UBIAir-Clinical & Experimental Lung Centre, University of Beira Interior, Covilhã, Portugal; Department of Immunoallergology, Cova da Beira University Hospital Centre, Covilhã, Portugal.
- Fundacion Jimenez Diaz, CIBERES, Faculty of Medicine, Autonoma University of Madrid, Madrid, Spain.
- Health Planning Unit, Department of Social Medicine, Faculty of Medicine, University of Crete, Crete, Greece; International Primary Care Respiratory Group IPCRG, Aberdeen, Scotland.
- Institute of Clinical Medicine and Institute of Health Sciences, Medical Faculty of Vilnius University, Vilnius, Lithuania.
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy.
- Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada.
- Department of Pulmonology, Celal Bayar University, Manisa, Turkey.
- University Clinic of Respiratory and Allergic Diseases, Golnick, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany; University Hospital Montpellier, Montpellier, France. Electronic address: jean.bousquet@orange.fr.
Abstract
Background: Several studies have suggested an impact of allergic rhinitis on academic productivity. However, large studies with real-world data (RWD) are not available.
Objective: To use RWD to assess the impact of allergic rhinitis on academic performance (measured through a visual analog scale [VAS] education and the Work Productivity and Activity Impairment Questionnaire plus Classroom Impairment Questions: Allergy Specific [WPAI+CIQ:AS] questionnaire), and to identify factors associated with the impact of allergic rhinitis on academic performance.
Methods: We assessed data from the MASK-air mHealth app of users aged 13 to 29 years with allergic rhinitis. We assessed the correlation between variables measuring the impact of allergies on academic performance (VAS education, WPAI+CIQ:AS impact of allergy symptoms on academic performance, and WPAI+CIQ:AS percentage of education hours lost due to allergies) and other variables. In addition, we identified factors associated with the impact of allergic symptoms on academic productivity through multivariable mixed models.
Results: A total of 13,454 days (from 1970 patients) were studied. VAS education was strongly correlated with the WPAI+CIQ:AS impact of allergy symptoms on academic productivity (Spearman correlation coefficient = 0.71 [95% confidence interval (CI) = 0.58; 0.80]), VAS global allergy symptoms (0.70 [95% CI = 0.68; 0.71]), and VAS nose (0.66 [95% CI = 0.65; 0.68]). In multivariable regression models, immunotherapy showed a strong negative association with VAS education (regression coefficient = -2.32 [95% CI = -4.04; -0.59]). Poor rhinitis control, measured by the combined symptom-medication score, was associated with worse VAS education (regression coefficient = 0.88 [95% CI = 0.88; 0.92]), higher impact on academic productivity (regression coefficient = 0.69 [95% CI = 0.49; 0.90]), and higher percentage of missed education hours due to allergy (regression coefficient = 0.44 [95% CI = 0.25; 0.63]).
Conclusion: Allergy symptoms and worse rhinitis control are associated with worse academic productivity, whereas immunotherapy is associated with higher productivity.
Keywords: Academic productivity; Allergic rhinitis; MASK; Mobile health; Real-world data.
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