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Table 5 An example of scaling up strategy: ARIA (Allergic Rhinitis and its Impact on Asthma) [21, 26]

From: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)

Allergic rhinitis is one of the most prevalent diseases in the world (25 % of the European Union population). Although symptoms of rhinitis appear to be trivial, the disease affects social activities as well as school and work performance [56]. It is often associated with or precedes asthma (including in the elderly) [57, 58]. Allergic rhinitis has been considered to alter AHA if not appropriately managed [7, 8]

 ARIA, a guideline for allergic rhinitis and its multimorbidity with asthma, is the first multimorbidity guideline in chronic diseases. It was developed in the early 2000s in collaboration with the World Health Organization using the recommended methodology for guidelines (Shekelle) [59]. It was updated in 2008 [60]

 It has been revised using the GRADE methodology (2010) [22, 61, 62]

 It is the most widely used guideline for rhinitis, and for rhinitis and asthma multimorbidity globally [21]

 The ARIA classification of allergic rhinitis severity has been used for the development of Health Technology Assessment guidelines, in particular in the US [63]

 ARIA recommendations have been adopted by government guidelines (Brazil, Portugal, Singapore)

 ARIA is implemented in 64 countries and the pocket guide of the guideline has been translated into 52 languages

 MASK-rhinitis (MACVIA–ARIA Sentinel NetworK for allergic rhinitis) is a care pathway centred around the use of Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on ARIA [26, 34]. This tool can be used by older adults

 Over 600 scientific papers have used ARIA for the classification of allergic rhinitis in clinical practice, clinical trials, as well as epidemiologic (from pre-school children to the elderly [58]), basic and translational research [21]