Understanding the needs and expectations of Ukrainian refugees with allergic diseases: the UCRAID@Apulia Pilot Study

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BACKGROUND/OBJECTIVES: The ongoing Ukrainian conflict constitutes a grave humanitarian emergency, with refugees facing significant language and cultural barriers hindering access to health care. The UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) initiative was launched to support Ukrainian refugees through the MASK-air® and CRUSE® apps. The UCRAID@Apulia study aimed to assess the feasibility of UCRAID via a joint medical and socio-linguistic approach. METHODS: A multidisciplinary, cross-sectional study was conducted from July 2023 to June 2024 involving adult Ukrainian refugees with asthma, allergic rhinitis, atopic dermatitis or chronic urticaria recruited via a network of Ukrainian associations and institutional partners. Participants were introduced to MASK-air® and CRUSE® and administered a 20-item questionnaire assessing sociocultural and healthcare needs, linguistic barriers, comorbidities (Charlson Comorbidity Index) and health-related quality of life (EQ-5D-5L). RESULTS: Among the 381 eligible patients being offered participation, 53 (13.91%) accepted enrolment. While literacy and occupation levels were high, issues with accommodation and bureaucracy were often cited. Mistrust and fear of reprisals emerged as key deterrents to participation. Chronic urticaria and atopic dermatitis were the prevalent allergic conditions. EQ-5D-5L showed good overall health but was characterized by anxiety/depression (32.1%) and pain (17%). Despite significant language barriers in both Italian and English, all participants successfully used both applications. At a 30-day follow-up, 71% reported at least 5 days of consecutive usage with high satisfaction. CONCLUSIONS: Despite low enrolment driven by fear and distrust, mHealth tools like MASK-air® and CRUSE® proved feasible and well-received, with trust building and long-term support being key elements for wider future adoption.

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