The role of mobile health technologies in allergy care: An EAACI position paper.

Mobile health (mHealth) uses mobile communication devices such as smartphones and tablet computers to support and improve health-related services, data and information flow, patient self-management, surveillance, and disease management from the moment of first diagnosis to an optimized treatment. The European Academy of Allergy and Clinical Immunology created a task force to assess the state of the art and future potential of mHealth in allergology. The task force endorsed the "Be He@lthy, Be Mobile" WHO initiative and debated the quality, usability, efficiency, advantages, limitations, and risks of mobile solutions for allergic diseases. The results are summarized in this position paper, analyzing also the regulatory background with regard to the "General Data Protection Regulation" and Medical Directives of the European Community. The task force assessed the design, user engagement, content, potential of inducing behavioral change, credibility/accountability, and privacy policies of mHealth products. The perspectives of healthcare professionals and allergic patients are discussed, underlining the need of thorough investigation for an effective design of mHealth technologies as auxiliary tools to improve quality of care. Within the context of precision medicine, these could facilitate the change in perspective from clinician- to patient-centered care. The current and future potential of mHealth is then examined for specific areas of allergology, including allergic rhinitis, aerobiology, allergen immunotherapy, asthma, dermatological diseases, food allergies, anaphylaxis, insect venom, and drug allergy. The impact of mobile technologies and associated big data sets are outlined. Facts and recommendations for future mHealth initiatives within EAACI are listed.

Romanian young adult perceptions on using heated tobacco products following exposure to direct marketing methods.

Heated tobacco products have a rapid uptake, especially among young people, mostly where advertising is unregulated, as is the case in Romania. This qualitative study explores the influence of direct marketing methods of heated tobacco products on young people, their perception and behaviour towards smoking. We have carried out 19 interviews with smokers of heated tobacco products (HTPs) or/and combustible cigarettes (CCs) or non-smokers (NS), aged 18-26. Using the thematic analysis, we have identified three overarching themes: (1) people, places, and subjects of marketing, (2) engagement with risk narratives and (3) social body, family bonds, and autonomous self. Even if most of the participants have been exposed to a mix of marketing methods, they did not acknowledge the influence that marketing has on their decision to experience smoking. Young adults' decision to use heated tobacco products seems to be influenced by a cluster of reasons: overcoming the legislation gap which prohibits indoor use of combustible cigarettes but not heated tobacco products; the attractivity of the product (novelty, inviting appearance, technological appeal and price) and presumed less damaging effects on health.

Barriers to the provision of smoking cessation assistance: a qualitative study among Romanian family physicians.

BACKGROUND: Smoking cessation is the most effective intervention to prevent and slow down the progression of several respiratory and other diseases and improve patient outcomes. Romania has legislation and a national tobacco control programme in line with the World Health Organization Framework for Tobacco Control. However, few smokers are advised to quit by their family physicians (FPs). AIM: To identify and explore the perceived barriers that prevent Romanian FPs from engaging in smoking cessation with patients. METHODS: A qualitative study was undertaken. A total of 41 FPs were recruited purposively from Bucharest and rural areas within 600 km of the city. Ten FPs took part in a focus group and 31 participated in semistructured interviews. Analysis was descriptive, inductive and themed, according to the barriers experienced. RESULTS: Five main barriers were identified: limited perceived role for FPs; lack of time during consultations; past experience and presence of disincentives; patients' inability to afford medication; and lack of training in smoking cessation skills. Overarching these specific barriers were key themes of a medical and societal hierarchy, which undermined the FP role, stretched resources and constrained care. CONCLUSIONS: Many of the barriers described by the Romanian FPs reflected universally recognised challenges to the provision of smoking cessation advice. The context of a relatively hierarchical health-care system and limitations of time and resources exacerbated many of the problems and created new barriers that will need to be addressed if Romania is to achieve the aims of its National Programme Against Tobacco Consumption.

[Information group--a solution to increase the efficacy of specialized intervention for smoking cessation]. / Grupul de informare--o solutie de crestere a eficacitatii consultatiei specializate pentru renuntarea la fumat.

Since 2007, in Romania, the Ministry of Health implements the national programme for tobacco control which contains also a sub-programme for sustaining smoking cessation through free treatment and counselling. Because the specialised intervention lasts too long (often more than 60 minutes) and the requests for support increased with a high rate, we had to identify methods to increase the efficacity of the intervention and, thus, the efficiency. According to this new situation, since January 2008, all the smokers asking for support to the Center for Smoking Cessation from the National Institute of Pneumology "Marius Nasta" had to participate to an "information group" prior to visit to the doctor or/and psychologist for specialized help. The aim of this group is to offer the common information needed by all smokers and does not have any elements of group therapy. During 1st January 2008 - 31st December 2009, 829 smokers asked for help in Bucharest centers, from which 585 addressed to the physicians and 288 to the psychologists, a percentage being referred to both specialists. The smokers who are going directly to the specialist tend to choose only one specialist (67,8% doctor and 24% psychologist); only 8,1% are going to both specialists. In the meantime, those smokers who are participating to the information group, are using the services of both counsellors: 30,8% comparing with 28,2% only to doctor and 9,4% only to psychologist. Comparing with the smokers who went directly to the doctor, the smokers who underwent the group of information had an increased succes rate at 3 months after quiting with 27,8%. Also, the percentage of "lost" persons decreased with 51%. Participation to the information group increases the likelihood of attendance to both specialists by 2,8 times. The common approach of the smoker increased the abstinence rate independently of the participation to the information group: 44% increase for smokers who participated to the information group, and 67,3% for persons that directly addressed to the physician. In conclusion, organising an information group will increase the double approach of the smoker (by physician and psychologist) which, in turn, will increase the success rate and the efficiency of the medical act.