Obtaining support (Table 5)
Supportive relationships have been shown to have a positive impact on the management and control of asthma and/or allergic disease and in the overall well-being of AYA. Effective communication and fostering positive views about treatment can improve self-management, adherence, asthma control and quality of life.33,35,38,43,44,53,58,86-89 An unsupportive family environment has been associated with poor outcomes.86Adolescents tend not to report asthma symptoms to their parents and care-givers. Enrolling the family in assisting the AYA to undertake self-management of their asthma and allergy may be recommended (Grade C).33,35,38,43,44,53,58,86-89 This can be gradually achieved over time, as appropriate to the age of the AYA. Simple modifications to the family’s routines to create time to take treatment may assist with adherence to therapy.43,44
From early adolescence onwards, along with growing independence, relationships de-centralise from the core family to peers, friends and other social networks. Social comparison and being part of the group become increasingly important. As a result, the AYA may feel embarrassed about their allergy and/or asthma due to fear of being perceived as different from their peers. To prevent this, it may be recommended to encourage AYA to let their friends know about their allergy and/or asthma and how they can help in an emergency (Grade C).29,31,32,45,59 Friends may be invited to clinic appointments or practical workshops where they can be provided with hands-on training in symptom recognition, the use of adrenaline auto-injectors and other aspects of emergency management of allergy and asthma.29,31,32,45,59
Promoting allergy and/or 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).33,45,61,62,90 Information about the nature of the allergic conditions, possible triggers and correct treatment may change their self-perception, and the perceptions of others, and enable improvement in self-management. Increased awareness may also help reduce allergy- and/or asthma-related bullying in schools and online.45,62,90
Teenagers like to use applications on their mobile phones and look for information on the internet; moreover patients have reported finding online support networks helpful.29,31,33,38,44,45,58-63,87,88 Signposting AYA to high quality reliable online resources about allergy and/or asthma (eg websites, moderated forums) where they can obtain age-appropriate information and advice may be recommended (Grade C).