Implementation of a structured, multidisciplinary transition programme
involving paediatric and adult HCP for 11-25 year age group |
Organization challenges reorganising service to deliver a paediatric/
adult clinic. |
Training for staff, checklist of skills and knowledge
for AYA patients, regular meetings between adult and paediatric teams,
audit process. |
Existence of a 11-25 year transition clinic. |
Some
initial investment may be required to reorganise the clinical
service. |
Medication reminders, mobile applications and web-based applications,
monitors or routines to improve adherence, symptom control and quality
of life |
Convincing families to change their routines. Expense of
information technology applications or monitors. |
The use of alarm
functions on devices such as mobile phones. |
Adherence to therapy. |
Simple changes to routines to facilitate adherence or the use of alarm
functions on devises such as mobile phones are inexpensive. Separate
mobile or web-based applications would be expensive. |
Focusing consultation on areas where AYA say they are not confident to
improve self-management including adherence |
Changing HCP approach
which focuses on a set approach to history taking in clinic. |
Training
for HCP so they understand the mind set of AYA and behavioural change
approaches. |
Survey of AYA patients to assess their confidence in
self-management. |
Resources for training HCP. |
Formulation of a personal action plan with the AYA and their family to
enable them to self-manage their allergy and asthma |
Time to develop
patient specific self-management plans. |
Generic personal action plans
that can be personalised to the needs of specific patients. |
Possession
of personal action plan by individual patients. |
Time to develop
patient specific self-management plans. |
Peer-led interventions to improve asthma related quality of life, asthma
knowledge and to reduce asthma related doctor visits and school absence |
Resistance and expense of involving peers in training AYA.
Availability of peers who have the same condition. |
Education of HCP
about the benefit of peer-led interventions. |
Asthma related quality of
life and control after peer-led interventions. |
Expense of involving
peers in training AYA. |
Supporting the AYA, family and the wider community to allow the AYA
inclusion in social events |
Resistance from teachers, sport club leader
and others in the community. |
Education of teachers, sport club leader
and others in the community as to how to safely manage the risks
associated with allergy and asthma. |
Access to social events by
patients with allergy and asthma. |
Costs associated with training and
education. |
Motivational interviewing to improved asthma symptoms and quality of
life |
Lack of time and expertise. |
Training for HCP and knowledge
about how improved self-management can reduce further healthcare
utilisation. |
Asthma related quality of life and control after use of
motivational interviewing. |
Expense of training and increased clinic
time, initially. |
Identification and management of psychological and socioeconomic issues
impacting disease control and health related quality of life |
Lack of
time in clinic to identify and assist in managing these. |
Training in
AYA care and awareness of importance of psychological and socioeconomic
issues. |
Survey of psychological and socioeconomic issues. |
Cost of
additional clinic time. Access to a psychologist within the allergy
service. |
Psychological interventions using a cognitive behavioural therapy based
or multi-systemic therapy approach to improve adherence, asthma
knowledge, self-management and symptom control |
Lack of time and
expertise. |
Training for HCP and knowledge about how improved
self-management can reduce further healthcare utilisation. |
Health
related quality of life and symptom control after use of these
psychological interventions. |
Expense of training and increased clinic
time, initially. Access to a psychologist within the allergy
service. |
Enrolling the family in assisting the AYA to take on the self-management
of their allergy and asthma |
Inflexible family routines and lack of
time. |
Involvement of families in clinic and explanation of benefits of
their support. |
Health related quality of life and symptom control
after use of these psychological interventions. |
Cost of possible
additional clinic time. |
Encouraging AYA to let their friends know about their asthma and allergy
and how to manage emergencies |
AYA embarrassment and concern that they
will be seen as different. |
Explanation that friends will be interested
in helping them. |
Survey of the involvement in friends in supporting
self-management. |
Cost of possible additional clinic time. Plus
resources directed at friends. |
Signposting AYA to high quality online resources about allergy and
asthma where they can obtain age-appropriate information and advice may
be recommended |
Information on websites or from forums that provided an
inaccurate picture of allergy and asthma. |
High quality websites or
moderated forums that can inform and support AYA with allergy and
asthma. |
Survey the use of website and moderated forum. |
Costs
associated with developing and maintaining websites and moderated
forums. |