Dermot Ryan

The University of Edinburgh | UoE · Usher Institute

Respiratory diseases remain a significant cause of global morbidity and mortality and primary care plays a central role in their prevention, diagnosis and management. An e-Delphi process was employed to identify and prioritise the current respiratory research needs of primary care health professionals worldwide. One hundred and twelve community-bas...

Systemic corticosteroids (SCS) are a highly effective treatment for acute exacerbations and long-term symptom control in asthma. Long-term SCS use is highly prevalent across all asthma severities, occurring in over 20% of patients with severe or uncontrolled disease globally. It is now well known that exposure to both long-term and repeated acute c...

Chronic rhinosinusitis (CRS) is known to affect around 5 % of the total population, with major impact on the quality of life of those severely affected (1). Despite a substantial burden on individuals, society and health economies, CRS often remains underdiagnosed, under-estimated and under-treated (2). International guidelines like the European Po...

Background: Urticaria is a common condition presenting both as acute and chronic disease within primary care. To those without specialist training it is poorly understood from the points of view of diagnosis and management. It causes a considerable disease burden to sufferers with marked impact on quality of life. Purpose of this review: The rec...

Introduction Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality in Europe; however, it is important to understand how clinical practice patterns differ between countries and how this might relate to disease outcomes, to identify ways of improving local disease management. We aimed to describe and compare the management of...

Most patients presenting with allergies are first seen by primary care health professionals. The perceived knowledge gaps and educational needs were recently assessed in response to which the LOGOGRAM Task Force was established with the remit of constructing pragmatic flow‐diagrams for common allergic conditions in line with an earlier EAACI propos...

Most patients presenting with allergies are first seen by primary care health professionals. The perceived knowledge gaps and educational needs were recently assessed in response to which the LOGOGRAM Task Force was established with the remit of constructing pragmatic flow-diagrams for common allergic conditions in line with an earlier EAACI propos...

Background Guidelines for management of patients with allergic conditions are available, but the added value of nurses, allied health care professionals (AHPs) and general practitioners (GPs), in the management of allergic disease has not been fully clarified. The European Academy of Allergy and Clinical Immunology (EAACI) appointed a task force to...

Purpose There remains a need for a standardized dataset for respiratory studies to accelerate data collection, improve research efficiency and aid the sharing, merging and comparison of datasets. This TORPEDO (Towards Optimum Reporting of Pulmonary Effectiveness Databases and Outcomes) project aimed to develop a checklist of optimum and minimum var...

Background Data to better understand and manage the COVID-19 pandemic is urgently needed. However, there are gaps in information stored within even the best routinely-collected electronic health records (EHR) including test results, remote consultations for suspected COVID-19, shielding, physical activity, mental health, and undiagnosed or untested...

Background: Guidelines for management of patients with allergic conditions are available, but the added value of nurses, allied health care professionals (AHPs) and general practitioners (GPs), in the management of allergic disease has not been fully clarified. The European Academy of Allergy and Clinical Immunology (EAACI) appointed a task force t...

EAACI-Leitlinien zur allergen-spezi-fischen Immuntherapie: Insektengiftall-ergie Die Insektengiftallergie ist eine poten-ziell lebensbedrohliche allergische Reakti-on auf Gifte von Hautflüglern (Hymenopte-ren) wie Honigbienen, Wespen und Ameisen. Systemische allergische Reaktionen auf die Stiche können bei bis zu 7,5% der Erwachse-nen und 3,4% der...

Guidelines aim to standardize and optimize asthma diagnosis and management. Nevertheless, adherence to guidelines is suboptimal and may vary across different healthcare professional (HCP) groups. Further to these concerns, this ERS/EAACI Statement aims (1) via an international online survey, to evaluate the understanding of and adherence to intern...

The aim of this survey was to explore the specific educational needs of a cohort of European GPs with regards to allergy training so that future educational initiatives may better support the delivery of allergy services in primary care. Method This study took the form of a cross-sectional observational study in which a structured electronic quest...

Introduction: Symptoms may persist after the initial phases of COVID-19 infection, a phenomenon termed long COVID. Current knowledge on long COVID has been mostly derived from test-confirmed and hospitalized COVID-19 patients. Data are required on the burden and predictors of long COVID in a broader patient group, which includes both tested and un...

BACKGROUND: Clinicians are increasingly recognizing severe asthma patients in whom biologics and other add-on therapies lead to dramatic improvement. Currently, there is no agreedupon super-responder (SR) definition. OBJECTIVE: To survey severe asthma experts using a modified Delphi process, to develop an international consensus-based definition of...

Contexte Le Royaume-Uni (UK) présente des taux de mortalité et d’hospitalisation pour Broncho Pneumopathie Chronique Obstructive (BPCO) plus élevés que ceux de la France. Ces différences pourraient être dues à des différences de prise en charge : le but de cette étude était de décrire la consommation de soins des patients BPCO et les coûts associés...

Allergen immunotherapy (AIT), the gradually increasing repeated administration of high doses of allergens to allergic patients, offers the potential for immune tolerance against reactions to the natural exposures to specific allergens. AIT may lead to the long-lasting remission of allergic symptoms and is the only disease-modifying intervention in...

Physicians still have great difficulty in diagnosing asthma. Over‐ and under diagnosis both occur for this lung disease from which around 300 million people suffer worldwide.¹ For diagnosing asthma, after careful history taking, lung function testing is considered the most relevant investigation. However, other parameters could also assist in compl...

Background Although there are many asymptomatic patients, one of the problems of COVID‐19 is early recognition of the disease. COVID‐19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID‐19 symptoms may be mistaken withthe common cold or allergic rhinitis. An ARIA‐EAACI study group attempted to differentiate upper r...

Background: The impact of hormone replacement therapy (HRT) on clinical outcomes in menopausal women is uncertain. Objective: To investigate the association between use of HRT and severe asthma exacerbation in peri-menopausal and post-menopausal women with asthma. Methods: We used the Optimum Patient Care Research Database, a population-based lon...

ABSTRACT Background: MP-AzeFlu (Dymista�; spray of azelastine/fluticasone propionate) is the most effective allergic rhinitis (AR) treatment available. Its effect on asthma outcomes in patients with AR and asthma is unknown. Methods: This pre-post historical cohort study, using the Optimum Patient Care Research Database, included patients aged �12...

Background Severe asthma may be under-recognized in primary care. Objective Identify and quantify patients with potential severe asthma (PSA) in UK primary care, the proportion not referred, and compare primary care PSA patients with confirmed severe asthma patients from UK tertiary care. Methods Historical cohort study including patients from the...

Background: There is uncertainty about the role of hormonal replacement therapy (HRT) in development of asthma. Objective: We investigated whether use of HRT and duration of use was associated with risk of developing asthma in peri- and post-menopausal women. Methods: We constructed a 17-year (1/1/2000 – 12/31/2016) open cohort of 353,173 women (...

Background The analysis of mobile health (mHealth) data has generated innovative insights into improving allergic rhinitis control, but additive information is needed. A cross-sectional real-world observational study was undertaken in 17 European countries during and outside the estimated pollen season. The aim was to collect novel information incl...

In 2019, it was reported that changes to asthma management reported in the Global Initiative for Asthma (GINA) "…might be considered the most fundamental changes in asthma management in 30 years." These changes refer to the recommendation that the treatment of asthma in adolescents and adults would no longer include short-acting ß2-agonist (SABA) o...

p>Allergic rhinitis (AR) is the most common chronic inflammatory disease, affecting an estimated 100 million Europeans (1). Despite a substantial burden on individuals, society and health economies (2), AR remains under-diagnosed, under-estimated (in terms of severity), and under-treated (3). Although effective and safe treatments exist, patients w...

Background: Longitudinal studies investigating impact of exogenous sex steroids on clinical outcomes of asthma in women are lacking. We investigated the association between use of hormonal contraceptives and risk of severe asthma exacerbation in reproductive-age women with asthma. Methods: We used the Optimum Patient Care Research Database, a popu...

Introduction: The Fostair® 100/6 (BDP/FF) pressurized metered-dose inhaler, delivering an extrafine formulation, is licensed for asthma and COPD in the UK. However, its real-life effectiveness for COPD has not been evaluated. This study compared the clinical effectiveness of BDP/FF against other licensed ICS/LABA combination inhalers: the Seretide...

Purpose: There is a dearth of research regarding the prevalence and nature of patient-reported rhinitis and its relationship with risk of asthma exacerbations. The aim of this study was to (i) determine the prevalence, severity and treatment of self-reported rhinitis symptoms among adults aged ≥18 years with asthma treated at Global Initiative for...

An amendment to this paper has been published and can be accessed via the original article.

Since the first description of anaphylaxis in 1902, its clinical importance as an emergency condition has been recognized worldwide. Anaphylaxis is a severe, potentially life-threatening systemic hypersensitivity reaction characterized by rapid onset and the potential to endanger life through respiratory or circulatory compromise. It is usually, al...

Large differences in COVID‐19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbag...

Background: Severe asthma is a serious condition with a significant burden on patients' morbidity, mortality, and quality of life. Some biological therapies targeting the IgE and interleukin-5 (IL5) mediated pathways are now available. Due to the lack of direct comparison studies, the choice of which medication to use varies. We aimed to explore t...

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 manag...

Mobile Health (mHealth) uses mobile communication devices such as smartphones and tablet computers to support and improve health‐related services, data flow and information, patient self‐management, surveillance, and disease management from the moment of first diagnosis to an optimized treatment. The European Academy of Allergy and Clinical Immunol...

Introduction L’urticaire est une dermatose fréquente, la majorité des cas sont d’abord vus par les médecins généralistes (MG) ou les urgences, et éventuellement par des allergologues sur orientation du MG. Cette revue systématique vise à créer un algorithme simple pour les soins primaires optimisant la prise en charge et l’orientation des patients....

Introduction L’HSM représente une cause de décès évitable importante. Les médecins de soins primaires (SP) constituent souvent le premier contact pour les patients présentant une HSM. Cette revue systématique vise à fournir des preuves afin de faciliter le développement d’outils d’aide à la décision aux médecins généralistes (MG). Méthodes Une rev...

Background Chronic rhinosinusitis (CRS) is a chronic inflammatory disease associated with a substantial personal and socio‐economic burden. Monitoring of patient‐reported outcomes by mobile technology offers the possibility to better understand real‐life burden of CRS. Methods This study reports on the cross‐sectional evaluation of data of 626 use...

Background Despite well-described sex differences in asthma incidence, there remains uncertainty about the role of female sex hormones in the development of asthma. Objective We sought to investigate whether hormonal contraceptive use, its subtypes, and duration of use were associated with new-onset asthma in reproductive-age women. Methods Using...

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an upd...

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 measure...

Factors related to the discrepancy between patient-perceived and actual disease control remain unclear. Identifying patients at risk of overestimation of asthma control remains elusive. This study aimed to (i) investigate the relationship between patient-reported and actual level of asthma control (ii), compare the characteristics between patients...

Aims Mobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurre...

Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy. Main body: As an example...

The selection of pharmacotherapy for patients with allergic rhinitis aims to control the disease and depends on many factors. Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines have considerably improved the treatment of allergic rhinitis. However, there is an increasing trend toward use of real-world evidence to i...

Purpose: In primary care, initial diagnosis of community-acquired pneumonia (CAP) is made on clinical judgment without radiological confirmation or knowledge of the causative organism. Use of CRB65 score has been recommended for assessing the severity of CAP and thereby determining clinical management, but it is not known how frequently these scor...

Despite the use of effective medications to control asthma, severe exacerbations in asthma are still a major health risk and require urgent action on the part of the patient and physician to prevent a serious outcome such as hospitalisation or death. Moreover, severe exacerbations are associated with substantial huge healthcare costs, and psycholog...

Bosnic-Anticevich S, Chrystyn H, Costello RW, et al. Int J Chron Obstruct Pulmon Dis. 2017;12:59–71. Upon reviewing the article, the authors noticed an error in Figure 2 (page 65). The position of the markers for the incidence rate ratio for moderate/severe exacerbations and the odds ratio for average daily SABA dose (OR) in the initial figure were...

Background: The European Position Papers on Rhinosinusitis from 2005, 2007 and 2012 have had a measurable impact on the way this common condition with high impact on quality of life is managed around the world. EPOS2020 will be the latest iteration of the guideline, addressing new stakeholders and target users, presenting a summary of the latest l...

Allergen immunotherapy (AIT) has been in use for the treatment of allergic disease for more than 100 years. Asthma treatment relies mainly on corticosteroids and other controllers recommended to achieve and maintain asthma control, prevent exacerbations, and improve quality of life. AIT is underused in asthma, both in children and in adults. Notabl...

Background: Mobile health can be used to generate innovative insights into optimizing treatment to improve allergic rhinitis (AR) control. Objectives: A cross-sectional real-world observational study was undertaken in 22 countries to complement a pilot study and provide novel information on medication use, disease control, and work productivity...