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Allergo Journal

, Volume 28, Issue 7, pp 20–46 | Cite as

ARIA-Leitlinie 2019: Behandlung der allergischen Rhinitis im deutschen Gesundheitssystem

  • Ludger Klimek
  • Claus Bachert
  • Oliver Pfaar
  • Sven Becker
  • Thomas Bieber
  • Randolf Brehler
  • Roland Buhl
  • Ingrid Casper
  • Adam Chaker
  • Wolfgang Czech
  • Jörg Fischer
  • Thomas Fuchs
  • Michael Gerstlauer
  • Karl Hörmann
  • Thilo Jakob
  • Kirsten Jung
  • Matthias V. Kopp
  • Vera Mahler
  • Hans Merk
  • Norbert Mülleneisen
  • Katja Nemat
  • Uta Rabe
  • Johannes Ring
  • Joachim Saloga
  • Wolfgang Schlenter
  • Carsten Schmidt-Weber
  • Holger Seyfarth
  • Annette Sperl
  • Thomas Spindler
  • Petra Staubach
  • Sebastian Strieth
  • Regina Treudler
  • Christian Vogelberg
  • Andrea Wallrafen
  • Wolfgang Wehrmann
  • Holger Wrede
  • Torsten Zuberbier
  • Anna Bedbrook
  • Giorgio W. Canonica
  • Victoria Cardona
  • Thomas B. Casale
  • Wienczylawa Czarlewski
  • Wytske J. Fokkens
  • Eckard Hamelmann
  • Peter W. Hellings
  • Marek Jutel
  • Désirée Larenas-Linnemann
  • Joaquim Mullol
  • Nikolaos G. Papadopoulos
  • Sanna Toppila-Salmi
  • Thomas Werfel
  • Jean BousquetEmail author
Leitlinie
  • 88 Downloads

Zusammenfassung

Hintergrund

Die Anzahl der von Allergien betroffenen Patienten nimmt weltweit zu. Hiermit gehen erhebliche Kosten für die Gesundheits- und Sozialsysteme durch allergische Erkrankungen einher. Integrierte Versorgungskonzepte sind erforderlich, die innerhalb der nationalen Gesundheitssysteme eine umfassende Versorgung ermöglichen. Die ARIA-Initiative entwickelt international gültige Leitlinien für allergische Atemwegserkrankungen.

Methoden

ARIA dient der verbesserten Versorgung von Patienten mit Allergien und chronischen Atemwegserkrankungen. In Zusammenarbeit mit anderen internationalen Initiativen, nationalen Fachgesellschaften und Patientenorganisationen im Bereich Allergien und Atemwegserkrankungen wurde eine realitätsnahe, integrative Versorgungsleitlinie („integrated care pathways“, ICPs) für eine digital unterstützte, integrative, individualisierte Behandlung von allergischer Rhinitis (AR) mit komorbidem Asthma entwickelt, die in der vorliegenden Arbeit auf das deutsche Gesundheitssystem übertragen wird.

Ergebnisse

Die vorliegende ICP-Versorgungsleitlinie umfasst wesentliche Bereiche der Versorgung von Patienten mit AR mit und ohne Asthma einschließlich der Sicht von Patienten und weiterer versorgungsnaher Gesundheitsdienstleister.

Diskussion

Eine umfassende ICP-Leitlinie kann die Versorgungsrealität wesentlich besser abbilden als herkömmliche Leitlinienmodelle.

Schlüsselwörter

allergische Erkrankungen allergisches Asthma integrated care pathway allergenspezifische Immuntherapie, Gesundheitssystem 

Abkürzungen

AEC

Allergen exposure chamber

AeDA

Ärzteverband deutscher Allergologen

AIRWAYS-ICPs’

Integrated care pathways for airway diseases

AIT

Allergenspezifische Immuntherapie

AMG

Arzneimittelgesetz

AMR

Arzneimittelrichtlinie

AR

Allergische Rhinitis

ARIA

Allergic rhinitis and its impact on asthma

CP

Centralized procedure

CRD

Chronic respiratory disease

DAAB

Deutscher Allergie- und Asthmabund

DBPCRCT

Double-blind placebo-controlled randomized clinical trial

DCP

Decentralized procedure

EAACI

European Academy for Allergy and Clinical Immunology

EG

Europäische Gemeinschaft

EIP on AHA

European Innovation Partnership on Active and Healthy Ageing

EIT

European Institute for Innovation and Technology

EMA

European Medicines Agency

EU

Europäische Union

G-BA

Gemeinsamer Bundesausschuss

GKV

Gesetzliche Krankenversicherung

GRADE

Grading of Recommendations Assessment, Development and Evaluation

ICER

Incremental cost effectiveness ratio

ICP

Integrated care pathway

INAH

Intranasale Antihistaminika

INCS

Intranasale Kortikosteroide

JA-CHRODIS

Joint Action on chronic diseases and promoting healthy ageing across the life cycle

KV

Krankenversicherung

LTRA

Leukotrienrezeptor-Antagonist

MACVIA

MAladies Chroniques pour un VIeillissement Actif (Fighting chronic diseases for active and healthy ageing)

MASK

Mobile Airways Sentinel Network

MASK-air

Formerly Allergy Diary

MPAzeFlu

Nasale Fixkombination aus Azelastin und Fluticason

MRP

Mutual recognition procedure

MS

Mitgliedsstaaten

NICE

National Institute for Health and Clinical Excellence (UK)

NIH

National Institute of Health (USA)

NPP

Named patients product

OAH

Orale Antihistaminika

OTC

Over the counter

PDC

Proportion of days covered

PEI

Paul-Ehrlich-Institut

POLLAR

Impact of air POLLution on Asthma and Rhinitis

RCT

Randomized controlled trials

RKI

Robert Koch-Institut

RMS

Reference Member State

RWE

Real-world evidence

SCIT

Subkutane Immuntherapie

SDM

Shared decision making

SLIT

Sublinguale Immuntherapie

TAV

Therapieallergeneverordnung

UAW

Unerwünschte Arzneimittelwirkung

VAS

Visual analogue scale

WHO

World Health Organization

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Ludger Klimek
    • 1
  • Claus Bachert
    • 2
    • 3
  • Oliver Pfaar
    • 4
  • Sven Becker
    • 5
  • Thomas Bieber
    • 6
    • 7
  • Randolf Brehler
    • 8
  • Roland Buhl
    • 9
  • Ingrid Casper
    • 1
  • Adam Chaker
    • 10
  • Wolfgang Czech
    • 11
  • Jörg Fischer
    • 12
  • Thomas Fuchs
    • 13
  • Michael Gerstlauer
    • 14
  • Karl Hörmann
    • 15
  • Thilo Jakob
    • 16
  • Kirsten Jung
    • 17
  • Matthias V. Kopp
    • 18
  • Vera Mahler
    • 19
  • Hans Merk
    • 20
  • Norbert Mülleneisen
    • 21
  • Katja Nemat
    • 22
  • Uta Rabe
    • 23
  • Johannes Ring
    • 24
    • 25
  • Joachim Saloga
    • 26
  • Wolfgang Schlenter
    • 27
  • Carsten Schmidt-Weber
    • 28
  • Holger Seyfarth
    • 29
  • Annette Sperl
    • 1
  • Thomas Spindler
    • 30
  • Petra Staubach
    • 26
  • Sebastian Strieth
    • 31
  • Regina Treudler
    • 32
  • Christian Vogelberg
    • 33
  • Andrea Wallrafen
    • 34
  • Wolfgang Wehrmann
    • 35
  • Holger Wrede
    • 36
  • Torsten Zuberbier
    • 37
  • Anna Bedbrook
    • 38
  • Giorgio W. Canonica
    • 39
  • Victoria Cardona
    • 40
  • Thomas B. Casale
    • 41
  • Wienczylawa Czarlewski
    • 42
  • Wytske J. Fokkens
    • 43
  • Eckard Hamelmann
    • 44
  • Peter W. Hellings
    • 45
  • Marek Jutel
    • 46
  • Désirée Larenas-Linnemann
    • 47
  • Joaquim Mullol
    • 48
  • Nikolaos G. Papadopoulos
    • 49
  • Sanna Toppila-Salmi
    • 50
  • Thomas Werfel
    • 51
  • Jean Bousquet
    • 52
    • 53
    Email author
  1. 1.Zentrum für Rhinologie und Allergologie WiesbadenWiesbadenDeutschland
  2. 2.Forschungslabor für obere Atemwege und Abteilung für Hals-Nasen-Ohren-HeilkundeUniversität Gent und Universitätsklinikum GentGentBelgien
  3. 3.Abteilung für HNO-Erkrankungen, CLINTEC, Karolinska-InstitutUniversität StockholmStockholmSchweden
  4. 4.Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Abteilung für Rhinologie und AllergologieUniversitätsklinikum Marburg, Philipps-Universität MarburgMarburgDeutschland
  5. 5.Klinik für Hals-, Nasen- und OhrenheilkundeUniversität TübingenTübingenDeutschland
  6. 6.Klinik für Dermatologie und AllergologieUniversität BonnBonnDeutschland
  7. 7.Christine Kühne - Zentrum für Allergieforschung und -bildung (CK-CARE) Davos-Augsburg-Bonn-St. Gallen-ZürichSt. GallenSchweiz
  8. 8.Universitätsklinikum Münster, Klinik für Allergologie, Arbeitsmedizin und UmweltmedizinMünsterDeutschland
  9. 9.LungenabteilungUniversitätsklinikum MainzDeutschland
  10. 10.Klinik für Hals-Nasen-Ohren-Heilkunde und Zentrum für Allergie & Umwelt (ZAUM), Klinikum rechts der IsarTechnische Universität und Helmholtz-Zentrum MünchenMünchenDeutschland
  11. 11.Klinik für DermatologieUniversität FreiburgFreiburgDeutschland
  12. 12.Klinik für DermatologieEberhard Karls Universität TübingenTübingenDeutschland
  13. 13.Universitätsmedizin Göttingen, Georg-August-UniversitätGöttingenDeutschland
  14. 14.Abteilung für Kinderpneumologie und AllergologieMedizinische Universität AugsburgAugsburgDeutschland
  15. 15.Klinik für Hals-Nasen-Ohren-HeilkundeUniversitätsklinikum MannheimMannheimDeutschland
  16. 16.Klinik für Dermatologie und AllergologieUniversitätsklinikum Gießen und Marburg, Campus Gießen, Justus-Liebig-UniversitätGießenDeutschland
  17. 17.ErfurtDeutschland
  18. 18.Klinik für Kinder- und JugendmedizinUniversität Lübeck, Airway Research Center North (ARCN), Mitglied des Deutschen Lungenzentrums (DZL)LübeckDeutschland
  19. 19.Klinik für DermatologieUniversitätsklinikum ErlangenErlangenDeutschland
  20. 20.Klinik für Dermatologie und AllergologieUniversitätsklinikum der RWTH AachenAachenDeutschland
  21. 21.Asthma- und AllergiezentrumLeverkusenDeutschland
  22. 22.Klinik für PädiatrieUniversitätsklinikum Carl Gustav Carus, Technische Universität DresdenDresdenDeutschland
  23. 23.Klinik für AllergologieJohanniter-Krankenhaus im Fläming Treuenbrietzen GmbHTreuenbrietzenDeutschland
  24. 24.Klinik und Poliklinik für Dermatologie und Allergologie am BiedersteinTechnische Universität MünchenMünchenDeutschland
  25. 25.Christine Kühne - Zentrum für Allergieforschung und -bildung (CK-Care)DavosSchweiz
  26. 26.Klinik für DermatologieUniversitätsklinikum MainzMainzDeutschland
  27. 27.Klinik für Hals-Nasen-OhrenheilkundeMedizinische Universität zu LübeckLübeckDeutschland
  28. 28.Zentrum für Allergie & Umwelt (ZAUM)Technische Universität München und Helmholtz-Zentrum MünchenMünchenDeutschland
  29. 29.Vorsitzender des Apothekenverbandes in HessenHessischer ApothekerverbandOffenbachDeutschland
  30. 30.Klinik für Pädiatrische Pneumologie und AllergologieLungenzentrum Süd-WestWangen im AllgäuDeutschland
  31. 31.Universitätsklinikum MainzMainzDeutschland
  32. 32.Klinik für Dermatologie, Venerologie und AllergologieUniversität Leipzig, Leipziger interdisziplinäres Centrum für Allergologie — LICALeipzigDeutschland
  33. 33.Klinik für Kinderpneumologie und AllergologieUniversitätsklinikum Carl Gustav Carus, Technische Universität DresdenDresdenDeutschland
  34. 34.Bundesgeschäftsführerin des Deutschen Allergie- und Asthmabundes DAABMönchengladbachDeutschland
  35. 35.MünsterDeutschland
  36. 36.Hals-, Nasen- und OhrenarztHerford, Nordrhein-WestfalenDeutschland
  37. 37.Klinik für Dermatologie und Allergologie, Allergie-Centrum-CharitéCharité - Universitätsmedizin BerlinBerlinDeutschland
  38. 38.MACVIA-France, Fondation partenariale FMC VIA-LRMontpellierFrankreich
  39. 39.Allergie und Atemwegserkrankungen, DIMIUniversität GenuaGenuaItalien
  40. 40.Klinik für Innere MedizinUniversitätsklinikum Vall d’HebronBarcelonaSpanien
  41. 41.Abteilung für Allergie und ImmunologieUniversity of South FloridaTampaUSA
  42. 42.Medizinische Beratung CzarlewskiLevalloisFrankreich
  43. 43.Abteilung OtorhinolaryngologieAkademische Medizinische ZentrenAmsterdamNiederlande
  44. 44.Kinderzentrum, Evangelisches Krankenhaus Bethel, Bielefeld und AllergiezentrumRuhr-Universität BochumBochumDeutschland
  45. 45.Klinik für Hals-Nasen-Ohren-HeilkundeUniversitätskliniken LeuvenLeuvenBelgien
  46. 46.Klinik für klinische ImmunologieMedizinische Universität Wroclaw und medizinisches Forschungsinstitut „ALL-MED“Wroclaw (Breslau)Polen
  47. 47.Krankenhaus Médica SurMéxico CityMéxico
  48. 48.Unitat de Rinologia i Clínica de l'Olfacte, Servei d'ORLUniversitat de Barcelona, Klinische und experimentelle respiratorische Immunallergie, IDIBAPS, CIBERESBarcelonaSpanien
  49. 49.Abteilung für Allergie, 2. KinderklinikUniversität AthenAthenGriechenland
  50. 50.Haartman-InstitutUniversität HelsinkiHelsinkiFinnland
  51. 51.Klinik für Immundermatologie und Allergieforschung, Klinik für Dermatologie und AllergieMedizinische Hochschule HannoverHannoverDeutschland
  52. 52.MACVIA-LR CHUMontpellierFrankreich
  53. 53.Centre Hospitalier Régional Universitaire de Montpellier (CHU)Montpellier Cedex 5Frankreich

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