Optimising self-management (Table 3)
Empowering AYA with self-management skills can help them become
autonomous, expert patients, minimising their dependency on parents and
HCP. It is therefore essential that AYA have the knowledge and skills to
ensure they can self-manage their allergies and/or asthma effectively
and confidently. Focusing consultations on areas where AYA say they are
not confident may be recommended to improve self-management including
adherence (Grade C).28-33 Barriers to successful
self-management such as poor symptom perception and failure to take
responsibility need to be addressed.7 Facilitators to
self-management which could be employed are the use of routines, simple
treatment regimes, better understanding, a positive attitude and support
from family, friends and school/college.7
To facilitate self-management, a personal action plan may be recommended
to assist AYA in self-managing their allergy and/or asthma (Grade
C).29,31,45,46 Plans should be developed with the AYA
and parents/carers which could be smartphone-based.46
Peer-led interventions are recommended to improve asthma-related quality
of life, asthma knowledge, and to reduce asthma-related doctor visits
and school absence (Grade A).47-51 Adolescents are
likely to mirror the behaviour of their peers. To date, these peer-led
interventions have been demonstrated in randomised controlled trials for
AYA with asthma; they may also be useful for other allergic conditions.
AYA with allergy and/or asthma are frequently excluded from activities,
which may have an impact on their developing social skills.
Consideration may be given to supporting the AYA, family and the wider
community to allow AYA to be included in social events (Grade
D).52-55 This may involve encouraging them to focus on
sports that are less likely to exacerbate asthma (e.g. swimming) or
undertake sport at times when symptoms are less likely to be triggered
(e.g. avoiding cold mornings or pollen peaks). Ensuring that the menu
for school trips or parties does not contain relevant food allergens
will be helpful for some AYA; it is therefore important that AYA develop
the necessary self-advocacy communication skills to inform organisers
about their allergy. Additionally, educating teachers, club staff, and
other parents about allergy/or and asthma is important as mistaken
beliefs can present a barrier to effective communication and integration
in social contexts.52,55
Motivational interviewing (MI) can be recommended to improve
understanding and perception of the disease and adherence, thereby
reducing asthma symptoms and improving quality of life (Grade
B).56 MI has been widely used in medicine and other
settings in this age group. The approach seeks to increase motivation to
change behaviours and then encourages the AYA to set goals for
themselves. Training is required for HCP to effectively utilise MI.