INtroduction
Adolescents and young adults (AYA) represent a large group of patients
with allergy and/or asthma. Their medical care is complicated by the
biological and psychosocial changes that occur during adolescence. As
AYA gain increasing autonomy, they also have to become more socially and
financially independent, whilst their primary relationships switch from
family to peer-based interactions. It is now acknowledged that these
changes encompass a much longer period than previously
thought1, continuing until around 25 years of age. For
these reasons, this guideline focuses on the 11-25 year age group.
The challenges faced by adolescence and early adulthood impact both on
the symptoms they experience and how these are managed; they also impact
on how the symptoms and management are perceived and accepted. AYA may
not fully understand the consequences of diseases. They may fail to take
responsibility for self-management, leading to suboptimal adherence to
treatment and other negative effects. This period of life is
particularly challenging because it occurs when AYA undergo numerous
life events linked with changes in education, work, travel and the
establishment of more mature relationships. In addition, many AYA are
transferred from paediatric to adult medical services, at the same time
as they may experience a sense of loss and fear of the unknown which may
lead to failure to follow up and more frequent hospitalizations.
Developmentally appropriate healthcare (DAH) recognizes the
biopsychosocial developmental changes of AYA and the need to empower
young people by embedding health education and health promotion in
consultations. It is critical for AYA to acquire the knowledge, skills
and confidence required to become independent, competent and expert
adult patients. This process is known as transition (Box 1) and entails
much more than the simple transfer of a patient from paediatric to adult
care. The process of transition is also important when an allergy clinic
caters for all age groups. If effectively learnt and utilized,
constructive self-management skills will serve to support patients
throughout their adult lives enabling them to achieve better health
outcomes. We know from a recent European survey that healthcare
professionals (HCP) find AYA to be a challenging group to
manage.2 To understand how to approach this age group,
it is necessary to understand what is happening during adolescence.