BACKGROUND: The number of patients affected by allergies is increasing worldwide. The resulting allergic diseases are leading to significant costs for health care and social systems. Integrated care pathways are needed to enable comprehensive care within the national health systems. The ARIA (Allergic Rhinitis and its Impact on Asthma) initiative develops internationally applicable guidelines for allergic respiratory diseases.
METHODS: ARIA serves to improve the care of patients with allergies and chronic respiratory diseases. In collaboration with other international initiatives, national associations and patient organizations in the field of allergies and respiratory diseases, real-life integrated care pathways have been developed for a digitally assisted, integrative, individualized treatment of allergic rhinitis (AR) with comorbid asthma. In the present work, these integrated care pathways have been adapted to the German situation and health system.
RESULTS: The present ICP (integrated care pathway) guideline covers key areas of the care of AR patients with and without asthma. It includes the views of patients and other healthcare providers.
CONCLUSIONS: A comprehensive ICP guideline can reflect real-life care better than traditional guideline models.

To improve continuity and coordination of care in geriatric rehabilitation, an integrated care pathway was developed in the south of the Netherlands. This study aims to reach nationwide consensus on the content and structure of this locally developed pathway using a two-round Delphi study with specialized elderly care physicians (n = 37) as experts. In the first round, experts indicated their level of agreement on 65 statements representing the pathway on a 5-point Likert-type scale. Statements that did not gain consensus (interquartile range > 1) were redistributed to participants in Round 2. Consensus was reached on 56 statements (86%) after Round 1 and on 60 statements (92%) after Round 2. In total, 53 statements were assessed as relevant, seven statements were considered irrelevant, and five statements did not reach consensus. We conclude that there is broad nationwide consensus on the pathway, which therefore has the potential to be disseminated and implemented on a wider scale.