The effectiveness of interventions to improve self‐management for adolescents and young adults with allergic conditions: A systematic review

Abstract

Background: This systematic review aimed to review the literature on interventions for improving self-management and well-being in adolescents and young adults (11-25 years) with asthma and allergic conditions. Methods: A systematic literature search was undertaken across eight databases. References were checked by two reviewers for inclusion. Study data were extracted, and their quality was assessed in duplicate. A narrative synthesis was undertaken. Results: A total of 30 papers reporting data from 27 studies were included. Interventions types were psychological (k = 9); e-health (k = 8); educational (k = 4); peer-led (k = 5); breathing retraining (k = 1). All interventions were for asthma. Psychological interventions resulted in significant improvements in the intervention group compared with the control group for self-esteem, quality of life, self-efficacy, coping strategies, mood and asthma symptoms. E-Health interventions reported significant improvements for inhaler technique, adherence and quality of life. General educational interventions demonstrated significantly improved quality of life, management of asthma symptoms, controller medication use, increased use of a written management plan and reduction in symptoms. The peer-led interventions included the Triple A (Adolescent Asthma Action) programme and a peer-led camp based on the Power Breathing Programme. Improvements were found for self-efficacy, school absenteeism and quality of life. Conclusion: Although significant improvements were seen for all intervention types, many were small feasibility or pilot studies, few studies reported effect sizes and no studies for allergic conditions other than asthma met the inclusion criteria. Research using large longitudinal interventional designs across the range of allergic conditions is required to strengthen the evidence base.

EAACI Guidelines on the effective transition of adolescents and young adults with allergy and asthma

“…Healthcare managers, research funding bodies and health policymakers may also find this guideline useful. The development of the guideline has been informed by two formal systematic reviews 8,9 with systematic review principles being used to identify additional evidence, where necessary. The guideline does not intend to provide advice about the management of individual allergic conditions in AYA.…”

The need for improved transition and services for adolescent and young adult patients with allergy and asthma in all settings

“…Examples include changing personal relationships, education and employment problems, depression and anxiety 3 . There are effective interventions for this age group 4 but their availability in clinical practice is limited.…”

Why we should focus on adolescents and young adults

“…Over the last three years, I have led a European Task Force looking at how we can improve the management and outcome of this age group (Figure 1). Our recently published systematic reviews 1,2 have documented the current state of the evidence. Healthcare professionals need to take into account the challenges faced by this age group around changing personal relationships, education and employment problems plus depression and anxiety 1,3,4 .…”

“…Healthcare professionals need to take into account the challenges faced by this age group around changing personal relationships, education and employment problems plus depression and anxiety 1,3,4 . More positively, there are some data on interventions for this age group 2 albeit much of the evidence is provisional. Perhaps the most important advance in our understanding of this age group is the realization that the major changes seen in the adolescent brain continue to around 25 years of age.…”