Starting transition
Preparation for transition may be considered from early adolescence (11-13 years) in accordance with the patient’s developmental stage (Grade D).13-19 This will allow AYA to gradually acquire new knowledge about their disease and develop self-management skills, allowing them to take increasing responsibility for their medical care. It is generally agreed that the optimal timing for initiation of the transition process cannot be based on chronological age. An individualised, flexible approach is required. The following factors might be considered by HCPs to determine the ideal age to start the transition process: mental and physical development, disease activity, health literacy, adherence to treatment, autonomy in disease management, family’s socioeconomic circumstances and school format (due to increased patient responsibility as move up the schooling system).
Transition readiness questionnaires are tools which consist of a list of desirable skills and educational targets that AYA should ideally meet before transfer to adult care.13,15,17,19 There is a lack of validated readiness assessment tools for AYA with allergy and/or asthma but several generic tools are available such as Transition Readiness Assessment Questionnaire20, “Ready, Steady, Go”21 and TR(x)ANSITION Scale22. HCP may consider using one throughout the transition process to track progress and identify areas where AYA need more help to build knowledge and understanding, autonomy and self-management skills (Grade D).