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P013 Using networks to facilitate international guideline implementation: allergic rhinitis as an example
  1. Jean Bousquet
  1. (France)


Allergic rhinitis and asthma represent global health problems for all age groups. Asthma and rhinitis frequently co-exist in the same subjects. Patients, clinicians and other health care professionals are confronted with various treatment choices for the management of allergic rhinitis. This contributes to considerable variation in clinical practice and, worldwide, patients, clinicians and other health care professionals are faced with uncertainty about the relative merits and downsides of the various treatment options. The outcomes of an expert workshop (ARIA: Allergic Rhinitis and its Impact on Asthma) held at the World Health Organization (WHO) in December 1999 were published in 2001. The ARIA workshop report was innovative in:

  • Proposing a new AR classification using persistence and severity of symptoms (mild/moderate-severe and intermittent/persistent).

  • Promoting the concept of co-morbidities in asthma and rhinitis as a key factor for patients’ management.

  • Developing guidelines in collaboration with relevant stakeholders including primary care physicians, and patients.

  • Including experts from developed and developing countries.

  • Adopting an evidence-based approach for the first time in guidelines on rhinitis.

  • Initiating global implementation among health care professionals and patients.

As new evidence about treatments for allergic rhinitis emerged, the methodology for guideline development changed. ARIA went with the times and move, after an evidence based update in 2008, to adopting the GRADE approach with its 2010 update. ARIA is disseminated and implemented in over 50 countries of the world. The Pocket Guide has been translated in 52 languages and it is arguably one of the most disseminated guidelines. We will report on the opportunities for international dissemination that evolved over time, report on how we accomplished it and how new media, such as Apps, can be used to facilitate the process of dissemination, using ARIA as an example.

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