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.