Usage patterns of oral H1-antihistamines in 10 European countries: A study using MASK-air® and Google Trends real-world data

Real-world data represent an increasingly important source of knowledge in health care. However, assessing their representativeness can be challenging. We compared (i) real-world data from a mobile app for allergic rhinitis (MASK-air®) on the usage of oral H1-antihistamines from 2016 to 2020 in 10 European countries with (ii) Google Trends data on the relative volume of searches for such antihistamines. For each country, we sorted 5 different oral H1-antihistamines by their frequency of use and volume of searches. We found perfect agreement on the order of antihistamine use in MASK-air® and in Google Trends searches in 4 countries (France, Germany, Sweden, and the United Kingdom). Different levels of agreement were observed in the remaining countries (kappa coefficient from -0.50 to 0.75). Oral H1-antihistamine data from Google Trends and MASK-air® were consistent with nationwide medication sales data from France, Germany, and the United Kingdom. These results suggest that MASK-air® data may be consistent with other sources of real-world data, although assessing the representativeness of their users may require further studies.