Enrolling the family in assisting the AYA to take on the self-management of their allergy and asthma may be recommended (Grade C, Evidence level IV) Enrolling the family in assisting the AYA to take on the self-management of their allergy and asthma may be recommended (Grade C, Evidence level IV) Enrolling the family in assisting the AYA to take on the self-management of their allergy and asthma may be recommended (Grade C, Evidence level IV)
Strength of recommendation: Moderate recommendation based on low to moderate risk of bias in qualitative 33,35,44,53,88 and observational studies38,43,58,86,87,89. These included AYA with both asthma33,35,38,43,44,53,86,87,89 and food allergy58,88. Other considerations: Support the family to slowly empower the AYA to take on more self-management as appropriate to the individual balancing autonomy and safety. Reducing control may be a challenge for some parents. Ask the AYA how they would like their parents/carers to be involved throughout their transition and help them develop confidence in working with the adult’s services18. Give AYA the chance to raise any concerns and queries separately from their parents/ carers respecting their confidentiality and autonomy. This may take more clinic time. Adherence may be improved if the family’s routines are modified to assist AYA self-management activities43,44.
References: Bruzzese89, Bruzzese43, Holley33, Koster38, Mammen53, Naimi35, Rhee86, Rhee87, Steensgaard58, Stewart88, Wamboldt44.
Encouraging AYA to let their friends know about their allergy and asthma and how to manage emergencies may be recommended (Grade C, Evidence level IV) Encouraging AYA to let their friends know about their allergy and asthma and how to manage emergencies may be recommended (Grade C, Evidence level IV) Encouraging AYA to let their friends know about their allergy and asthma and how to manage emergencies may be recommended (Grade C, Evidence level IV)
Strength of recommendation: Moderate recommendation based on low to moderate risk of bias in qualitative32,59 and observational studies29,31,45.These included AYA with asthma32, anaphylaxis59 and food allergy29,31,45.
Other considerations: Some AYA may find this difficult, they may require support and be encouraged to initially just talk to a few close friends. Provide practical training in symptom’s recognition, the use of adrenaline autoinjectors and other aspects of emergency management for friends. Some AYA may want to bring a friend to the clinic for support.
References: Gallagher59, Jones29, Jones31, MacAdam32, Warren45.
Promoting allergy and asthma awareness (e.g. triggers and treatment) among peers/ co-workers and teachers/ managers to support the AYA patient with self-management may be recommended (Grade C, Evidence level IV) Promoting allergy and asthma awareness (e.g. triggers and treatment) among peers/ co-workers and teachers/ managers to support the AYA patient with self-management may be recommended (Grade C, Evidence level IV) Promoting allergy and asthma awareness (e.g. triggers and treatment) among peers/ co-workers and teachers/ managers to support the AYA patient with self-management may be recommended (Grade C, Evidence level IV)
Strength of recommendation: Moderate recommendation as based on low risk of bias in qualitative33,61 and one observational study45.These included AYAs with both asthma33 and food allergy45,61. Other considerations: Efforts should be made to reduce asthma and allergy related bullying especially in schools45,62,90 and online62. References: Fong90, Gibson-Young62, Holley33, Monks61, Warren45.
Signposting AYA to high quality online resources about allergy and asthma (websites, moderated forums) where they can obtain age-appropriate information and advice may be recommended (Grade C, Evidence level IV) Signposting AYA to high quality online resources about allergy and asthma (websites, moderated forums) where they can obtain age-appropriate information and advice may be recommended (Grade C, Evidence level IV) Signposting AYA to high quality online resources about allergy and asthma (websites, moderated forums) where they can obtain age-appropriate information and advice may be recommended (Grade C, Evidence level IV)
Strength of recommendation: Moderate recommendation based on low to moderate risk of bias qualitative33,44,59-61 and observational studies29,31,38,45,58,62,63,87,88,91. These included AYA with asthma33,38,44,60,62,87,88, anaphylaxis59, allergy91 and food allergy29,31,45,58,61,63. Other considerations: Patients consider online supportive networks to be helpful. Peer support groups may be helpful, for example, voluntary- and community-sector organisations, such as condition specific support groups or charities13,18. Social networks via virtual platforms or electronic communication may be helpful13,18. Moderation of the group is desirable to ensure that interactions within the group are positive.
References: Bruzzese43, Gallagher59, Gibson-Young62, Hullmann63, Holley33, Jones29, Jones31, Jonsson60, Koster38, Monks61, Rhee87, Stewart88, Steensgaard58, Suorsa91, Warren45 Wombald44.