Academic productivity of young people with allergic rhinitis: a MASK-air study

Rafael José Vieira, Nhân Pham-Thi, Josep M. Anto, Wienczyslawa Czarlewski, Ana Sá-Sousa, Rita Amaral, Anna Bedbrook, Sinthia Bosnic-Anticevich, Luisa Brussino, G. Walter Canonica, Lorenzo Cecchi, Alvaro A. Cruz, Wytske J. Fokkens, Bilun Gemicioglu, Tari Haahtela, Juan Carlos Ivancevich, Ludger Klimek, Piotr Kuna, Violeta Kvedariene, Désirée Larenas-LinnemannMario Morais-Almeida, Joaquim Mullol, Marek Niedoszytko, Yoshitaka Okamoto, Nikolaos G. Papadopoulos, Vincenzo Patella, Oliver Pfaar, Frederico S. Regateiro, Sietze Reitsma, Philip W. Rouadi, Boleslaw Samolinski, Aziz Sheikh, Luis Taborda-Barata, Sanna Toppila-Salmi, Joaquin Sastre, Ionna Tsiligianni, Arunas Valiulis, Maria Teresa Ventura, Susan Waserman, Arzu Yorgancioglu, Mihaela Zidarn, Torsten Zuberbier, João A. Fonseca, Jean Bousquet, Bernardo Sousa-Pinto, MASK study group

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


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.
Original languageEnglish
Pages (from-to)3008-3017.e4
Number of pages14
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number11
Publication statusPublished - 20 Aug 2022
Externally publishedYes


  • Allergic rhinitis
  • MASK
  • Real-world data
  • Mobile health
  • Academic productivity


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