Browsing by Subject "rhinitis"

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  • ARIA Working Grp; Bousquet, J; Pfaar, O; Togias, A; Haahtela, T; Toppila-Salmi, S (2019)
    Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including healthcare professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow-up of patients.
  • MASK Grp; Menditto, Enrica; Costa, Elisio; Midao, Luis; Haahtela, Tari; Toppila-Salmi, S.; Kuitunen, M.; Valovirta, E. (2019)
    Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries. Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App. Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach. Results: A total of 12143 users were registered. A total of 6949 users reported at least one VAS data recording. Among them, 1887 users reported >= 7 VAS data. About 1195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR >= 70% and PDC = 70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting.
  • ARIA-MASK Study Grp; Bousquet, J.; Farrell, J.; Illario, M.; Haahtela, T.; Toppila-Salmi, S.; Valovirta, E. (2020)
    The reference sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) were renewed in 2019. The DG Sante good practice Mobile Airways Sentinel networK was reviewed to meet the objectives of the EIP on AHA. It included 1) Management of care process, 2) Blueprint of digital transformation, 3) EIP on AHA, innovation to market, 4) Community for monitoring and assessment framework, 5) Political, organizational, technological and financial readiness, 6) Contributing to European co-operation and transferability, 7) Delivering evidence of impact against the triple win approach, 8) Contribution to the European Digital Transformation of Health and Care and 9) scale of demonstration and deployment of innovation.
  • Mobile Airways Sentinel Network M; Bousquet, Jean; Hellings, Peter W.; Agache, Ioana; Haahtela, T.; Toppila-Salmi, S.; Kuitunen, M.; Valovirta, E.; Salimäki, Johanna; Vasankari, Tuula; Eklund, P.; Karjalainen, J.; Zuberbier, Torsten (2019)
    Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.
  • Bousquet, Jean; Anto, Josep M.; Bachert, Claus; Haahtela, Tari; Zuberbier, Torsten; Czarlewski, Wienczyslawa; Bedbrook, Anna; Bosnic-Anticevich, Sinthia; Walter Canonica, G.; Cardona, Victoria; Costa, Elisio; Cruz, Alvaro A.; Erhola, Marina; Fokkens, Wytske J.; Fonseca, Joao A.; Illario, Maddalena; Ivancevich, Juan-Carlos; Jutel, Marek; Klimek, Ludger; Kuna, Piotr; Kvedariene, Violeta; Le, L. T. T.; Larenas-Linnemann, Desiree E.; Laune, Daniel; Lourenco, Olga M.; Melen, Erik; Mullol, Joaquim; Niedoszytko, Marek; Odemyr, Mikaela; Okamoto, Yoshitaka; Papadopoulos, Nikos G.; Patella, Vincenzo; Pfaar, Oliver; Pham-Thi, Nhan; Rolland, Christine; Samolinski, Boleslaw; Sheikh, Aziz; Sofiev, Mikhail; Suppli Ulrik, Charlotte; Todo-Bom, Ana; Tomazic, Peter-Valentin; Toppila-Salmi, Sanna; Tsiligianni, Ioanna; Valiulis, Arunas; Valovirta, Erkka; Ventura, Maria-Teresa; Walker, Samantha; Williams, Sian; Yorgancioglu, Arzu; Agache, Ioana; Akdis, Cezmi A.; Almeida, Rute; Ansotegui, Ignacio J.; Annesi-Maesano, Isabella; Arnavielhe, Sylvie; Basagana, Xavier; D. Bateman, Eric; Bedard, Annabelle; Bedolla-Barajas, Martin; Becker, Sven; Bennoor, Kazi S.; Benveniste, Samuel; Bergmann, Karl C.; Bewick, Michael; Bialek, Slawomir; E. Billo, Nils; Bindslev-Jensen, Carsten; Bjermer, Leif; Blain, Hubert; Bonini, Matteo; Bonniaud, Philippe; Bosse, Isabelle; Bouchard, Jacques; Boulet, Louis-Philippe; Bourret, Rodolphe; Boussery, Koen; Braido, Fluvio; Briedis, Vitalis; Briggs, Andrew; Brightling, Christopher E.; Brozek, Jan; Brusselle, Guy; Brussino, Luisa; Buhl, Roland; Buonaiuto, Roland; Calderon, Moises A.; Camargos, Paulo; Camuzat, Thierry; Caraballo, Luis; Carriazo, Ana-Maria; Carr, Warner; Cartier, Christine; Casale, Thomas; Cecchi, Lorenzo; Cepeda Sarabia, Alfonso M.; H. Chavannes, Niels; Chkhartishvili, Ekaterine; Chu, Derek K.; Cingi, Cemal; Correia de Sousa, Jaime; Costa, David J.; Courbis, Anne-Lise; Custovic, Adnan; Cvetkosvki, Biljana; D'Amato, Gennaro; da Silva, Jane; Dantas, Carina; Dokic, Dejan; Dauvilliers, Yves; De Feo, Giulia; De Vries, Govert; Devillier, Philippe; Di Capua, Stefania; Dray, Gerard; Dubakiene, Ruta; Durham, Stephen R.; Dykewicz, Marc; Ebisawa, Motohiro; Gaga, Mina; El-Gamal, Yehia; Heffler, Enrico; Emuzyte, Regina; Farrell, John; Fauquert, Jean-Luc; Fiocchi, Alessandro; Fink-Wagner, Antje; Fontaine, Jean-Francois; Fuentes Perez, Jose M.; Gemicioglu, Bilun; Gamkrelidze, Amiran; Garcia-Aymerich, Judith; Gevaert, Philippe; Gomez, Rene Maximiliano; Gonzalez Diaz, Sandra; Gotua, Maia; Guldemond, Nick A.; Guzman, Maria-Antonieta; Hajjam, Jawad; Huerta Villalobos, Yunuen R.; Humbert, Marc; Iaccarino, Guido; Ierodiakonou, Despo; Iinuma, Tomohisa; Jassem, Ewa; Joos, Guy; Jung, Ki-Suck; Kaidashev, Igor; Kalayci, Omer; Kardas, Przemyslaw; Keil, Thomas; Khaitov, Musa; Khaltaev, Nikolai; Kleine-Tebbe, Jorg; Kouznetsov, Rostislav; Kowalski, Marek L.; Kritikos, Vicky; Kull, Inger; La Grutta, Stefania; Leonardini, Lisa; Ljungberg, Henrik; Lieberman, Philip; Lipworth, Brian; Lodrup Carlsen, Karin C.; Lopes-Pereira, Catarina; Loureiro, Claudia C.; Louis, Renaud; Mair, Alpana; Mahboub, Bassam; Makris, Michael; Malva, Joao; Manning, Patrick; Marshall, Gailen D.; Masjedi, Mohamed R.; Maspero, Jorge F.; Carreiro-Martins, Pedro; Makela, Mika; Mathieu-Dupas, Eve; Maurer, Marcus; De Manuel Keenoy, Esteban; Melo-Gomes, Elisabete; Meltzer, Eli O.; Menditto, Enrica; Mercier, Jacques; Micheli, Yann; Miculinic, Neven; Mihaltan, Florin; Milenkovic, Branislava; Mitsias, Dimitirios I.; Moda, Giuliana; Mogica-Martinez, Maria-Dolores; Mohammad, Yousser; Montefort, Steve; Monti, Ricardo; Morais-Almeida, Mario; Mosges, Ralph; Munter, Lars; Muraro, Antonella; Murray, Ruth; Naclerio, Robert; Napoli, Luigi; Namazova-Baranova, Leyla; Neffen, Hugo; Nekam, Kristoff; Neou, Angelo; Nordlund, Bjorn; Novellino, Ettore; Nyembue, Dieudonne; O'Hehir, Robyn; Ohta, Ken; Okubo, Kimi; Onorato, Gabrielle L.; Orlando, Valentina; Ouedraogo, Solange; Palamarchuk, Julia; Pali-Scholl, Isabella; Panzner, Peter; Park, Hae-Sim; Passalacqua, Gianni; Pepin, Jean-Louis; Paulino, Ema; Pawankar, Ruby; Phillips, Jim; Picard, Robert; Pinnock, Hilary; Plavec, Davor; Popov, Todor A.; Portejoie, Fabienne; Price, David; Prokopakis, Emmanuel P.; Psarros, Fotis; Pugin, Benoit; Puggioni, Francesca; Quinones-Delgado, Pablo; Raciborski, Filip; Rajabian-Soderlund, Rojin; Regateiro, Frederico S.; Reitsma, Sietze; Rivero-Yeverino, Daniela; Roberts, Graham; Roche, Nicolas; Rodriguez-Zagal, Erendira; Rolland, Christine; Roller-Wirnsberger, Regina E.; Rosario, Nelson; Romano, Antonino; Rottem, Menachem; Ryan, Dermot; Salimaki, Johanna; Sanchez-Borges, Mario M.; Sastre, Joaquin; Scadding, Glenis K.; Scheire, Sophie; Schmid-Grendelmeier, Peter; Schunemann, Holger J.; Sarquis Serpa, Faradiba; Shamji, Mohamed; Sisul, Juan-Carlos; Sofiev, Mikhail; Sole, Dirceu; Somekh, David; Sooronbaev, Talant; Sova, Milan; Spertini, F.; Spranger, Otto; Stellato, Cristiana; Stelmach, Rafael; Thibaudon, Michel; To, Teresa; Toumi, Mondher; Usmani, Omar; Valero, Antonio A.; Valenta, Rudolph; Valentin-Rostan, Marylin; Pereira, Marilyn Urrutia; van der Kleij, Rianne; Van Eerd, Michiel; Vandenplas, Olivier; Vasankari, Tuula; Vaz Carneiro, Antonio; Vezzani, Giorgio; Viart, Frederic; Viegi, Giovanni; Wallace, Dana; Wagenmann, Martin; Wang, De Yun; Waserman, Susan; Wickman, Magnus; Williams, Dennis M.; Wong, Gary; Wroczynski, Piotr; Yiallouros, Panayiotis K.; Yusuf, Osman M.; Zar, Heather J.; Zeng, Stephane; Zernotti, Mario E.; Zhang, Luo; Shan Zhong, Nan; Zidarn, Mihaela (2021)
    Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
  • MASK Study GroupJr; Bedard, Annabelle; Anto, Josep M.; Fonseca, Joao A.; Toppila-Salmi, Sanna; Basagana, Xavier (2020)
    Background In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. Methods All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. Results A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. Conclusions VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.
  • Bousquet, J.; Anto, J. M.; Akdis, M.; Auffray, C.; Keil, T.; Momas, I.; Postma, D. S.; Valenta, R.; Wickman, M.; Cambon-Thomsen, A.; Haahtela, T.; Lambrecht, B. N.; Carlsen, K. C. Lodrup; Koppelman, G. H.; Sunyer, J.; Zuberbier, T.; Annesi-Maesano, I.; Arno, A.; Bindslev-Jensen, C.; De Carlo, G.; Forastiere, F.; Heinrich, J.; Kowalski, M. L.; Maier, D.; Melen, E.; Palkonen, S.; Smit, H. A.; Standl, M.; Wright, J.; Asarnoj, A.; Benet, M.; Ballardini, N.; Garcia-Aymerich, J.; Gehring, U.; Guerra, S.; Hohman, C.; Kull, I.; Lupinek, C.; Pinart, M.; Skrindo, I.; Westman, M.; Smagghe, D.; Akdis, C.; Albang, R.; Anastasova, V.; Anderson, N.; Bachert, C.; Ballereau, S.; Ballester, F.; Basagana, X.; Bedbrook, A.; Bergstrom, A.; von Berg, A.; Brunekreef, B.; Burte, E.; Carlsen, K. H.; Chatzi, L.; Coquet, J. M.; Curin, M.; Demoly, P.; Eller, E.; Fantini, M. P.; Gerhard, B.; Hammad, H.; von Hertzen, L.; Hovland, V.; Jacquemin, B.; Just, J.; Keller, T.; Kerkhof, M.; Kiss, R.; Kogevinas, M.; Koletzko, S.; Lau, S.; Lehmann, I.; Lemonnier, N.; McEachan, R.; Mäkelä, M.; Mestres, J.; Minina, E.; Mowinckel, P.; Nadif, R.; Nawijn, M.; Oddie, S.; Pellet, J.; Pin, I.; Porta, D.; Ranciere, F.; Rial-Sebbag, A.; Saeys, Y.; Schuijs, M. J.; Siroux, V.; Tischer, C. G.; Torrent, M.; Varraso, R.; De Vocht, J.; Wenger, K.; Wieser, S.; Xu, C. (2016)
    MeDALL (Mechanisms of the Development of ALLergy; EU FP7-CP-IP; Project No: 261357; 2010-2015) has proposed an innovative approach to develop early indicators for the prediction, diagnosis, prevention and targets for therapy. MeDALL has linked epidemiological, clinical and basic research using a stepwise, large-scale and integrative approach: MeDALL data of precisely phenotyped children followed in 14 birth cohorts spread across Europe were combined with systems biology (omics, IgE measurement using microarrays) and environmental data. Multimorbidity in the same child is more common than expected by chance alone, suggesting that these diseases share causal mechanisms irrespective of IgE sensitization. IgE sensitization should be considered differently in monosensitized and polysensitized individuals. Allergic multimorbidities and IgE polysensitization are often associated with the persistence or severity of allergic diseases. Environmental exposures are relevant for the development of allergy-related diseases. To complement the population-based studies in children, MeDALL included mechanistic experimental animal studies and in vitro studies in humans. The integration of multimorbidities and polysensitization has resulted in a new classification framework of allergic diseases that could help to improve the understanding of genetic and epigenetic mechanisms of allergy as well as to better manage allergic diseases. Ethics and gender were considered. MeDALL has deployed translational activities within the EU agenda.
  • Toppila-Salmi, Sanna; Chanoine, Sebastien; Karjalainen, Jussi; Pekkanen, Juha; Bousquet, Jean; Siroux, Valerie (2019)
    Background The aim was to study the association between allergic multimorbidity and adult-onset asthma considering the number of allergic diseases and the age effect. Methods We used population-based data from Finnish national registers including 1205 adults over 30 years of age with recently diagnosed asthma (age range: 30-93), matched for gender, age, and living region with one or two controls (n = 2050). Allergic rhinitis (AR), allergic conjunctivitis (AC), and allergic dermatitis (AD) were defined from self-completed questionnaire. Conditional logistic regression adjusted on potential confounders (smoking, growing in countryside, childhood hospitalized infection/pneumonia, parental asthma/allergy, parental smoking, education level, professional training, number of siblings, and birth order) was applied to estimate the asthma risk associated with allergic multimorbidity. Results A total of 1118 cases with asthma and 1772 matched controls were included [mean (SD, min-max) 53 (11, 31-71) years, 37% men)]. AR, AC, and AD were reported by 50.2%, 39.6%, and 33.8%, respectively, among subjects with asthma and 26.1%, 20.0%, and 23.5%, respectively, among controls. Compared to nonatopics, adult-onset asthma increased with the number of allergic diseases; adjusted OR for asthma [95% CI] associated with 1, 2, and 3 allergic diseases was 1.95 [1.52-2.49], 2.87 [2.19-3.77], and 4.26 [3.07-5.90], respectively. The association between adult-onset asthma and >= 1 allergic multimorbidity decreased with increasing age (3.52 [2.51-4.94], 2.44 [1.74-3.42], and 1.68 [1.04-2.71]) in subjects <50 years, 50-62 years, and > 62 years, respectively (p for age*>= 1 allergic multimorbidity interaction, 0.002). Conclusions Adult-onset asthma was positively associated with the number of allergic diseases, and this association decreases with age.
  • Biedermann, T; Couroux, P; Greve, TM; Makela, M (2021)
    Background The standardized quality (SQ) tree sublingual immunotherapy (SLIT)-tablet has recently been approved for treatment of tree pollen allergy. Healthcare workers should be provided with detailed safety data for clinical use. Objective To assess the tolerability and safety of the SQ tree SLIT-tablet (12 SQ-Bet) in adults and adolescents. Methods Safety data were pooled from three double-blinded, randomized, placebo-controlled trials (2 phase-II/1 phase-III) including adults and adolescents 12-65 years with allergic rhinitis and/or conjunctivitis treated before and during one pollen season once-daily with 12 SQ-Bet (n = 471) or placebo (n = 458): EudraCT no: 2012-000031-59; NCT02481856; EudraCT 2015-004821-15. Results The most frequently reported investigational medicinal product (IMP)-related AEs with 12 SQ-Bet were oral pruritis (39% of subjects) and throat irritation (29%). IMP-related AEs were mainly mild or moderate in severity, and the majority resolved without treatment and did not lead to treatment interruption/discontinuation. With 12 SQ-Bet, oral pruritus was more frequent among subjects with pollen food syndrome (PFS) (45%) than without PFS (29%). The 12 SQ-Bet did not seem to induce an increased risk of asthma: 7 events were reported in 7 subjects with 12 SQ-Bet and 11 in 10 subjects with placebo. No differences were seen in the risk of moderate-to-severe IMP-related AEs regardless of age, PFS status and asthma medical history. Conclusions The 12 SQ tree SLIT-tablet was well tolerated in tree pollen allergic subjects with no major safety concerns detected. This safety profile supports daily at-home sublingual administration once the first dose is tolerated when administered under medical supervision.
  • Bousquet, J.; Devillier, P.; Arnavielhe, S.; Bedbrook, A.; Alexis-Alexandre, G.; van Eerd, M.; Murray, R.; Canonica, G. W.; Illario, M.; Menditto, E.; Passalacqua, G.; Stellato, C.; Triggiani, M.; Carreiro-Martins, P.; Fonseca, J.; Morais Almeida, M.; Nogueira-Silva, L.; Pereira, A. M.; Todo Bom, A.; Bosse, I.; Caimmi, D.; Demoly, P.; Fontaine, J. F.; Just, J.; Onorato, G. L.; Kowalski, M. L.; Kuna, P.; Samolinski, B.; Anto, J. M.; Mullol, J.; Valero, A.; Tomazic, P. V.; Bergmann, K. C.; Keil, T.; Klimek, L.; Moesges, R.; Shamai, S.; Zuberbier, T.; Murphy, E.; McDowall, P.; Price, D.; Ryan, D.; Sheikh, A.; Chavannes, N. H.; Fokkens, W. J.; Kvedariene, V.; Valiulis, A.; Bachert, C.; Hellings, P. W.; Kull, I.; Melen, E.; Wickman, M.; Bindslev-Jensen, C.; Eller, E.; Haahtela, T.; Papadopoulos, N. G.; Annesi-Maesano, I.; Bewick, M.; Bosnic-Anticevich, S.; Cruz, A. A.; De Vries, G.; Gemicioglu, B.; Larenas-Linnemann, D.; Laune, D.; Mathieu-Dupas, E.; O'Hehir, R. E.; Pfaar, O.; Portejoie, F.; Siroux, V.; Spranger, O.; Valovirta, E.; VandenPlas, O.; Yorgancioglu, A. (2018)
    BackgroundLarge observational implementation studies are needed to triangulate the findings from randomized control trials as they reflect real-world everyday practice. In a pilot study, we attempted to provide additional and complementary insights on the real-life treatment of allergic rhinitis (AR) using mobile technology. MethodsA mobile phone app (Allergy Diary, freely available in Google Play and Apple App stores) collects the data of daily visual analog scales (VAS) for (i) overall allergic symptoms, (ii) nasal, ocular, and asthma symptoms, (iii) work, as well as (iv) medication use using a treatment scroll list including all medications (prescribed and over the counter (OTC)) for rhinitis customized for 15 countries. ResultsA total of 2871 users filled in 17 091 days of VAS in 2015 and 2016. Medications were reported for 9634 days. The assessment of days appeared to be more informative than the course of the treatment as, in real life, patients do not necessarily use treatment on a daily basis; rather, they appear to increase treatment use with the loss of symptom control. The Allergy Diary allowed differentiation between treatments within or between classes (intranasal corticosteroid use containing medications and oral H1-antihistamines). The control of days differed between no [best control], single, or multiple treatments (worst control). ConclusionsThis study confirms the usefulness of the Allergy Diary in accessing and assessing everyday use and practice in AR. This pilot observational study uses a very simple assessment (VAS) on a mobile phone, shows novel findings, and generates new hypotheses.