Improved Transition Management of Adolescents and Young Adults With Allergy and/or Asthma: An EAACI Task Force Report on a Follow-Up European Survey

Abstract

Background Adolescents and young adults (AYA) with asthma and allergies have unexpectedly high mortality and morbidity. A survey in 2019 amongst healthcare professionals (HCPs) in Europe highlighted significant gaps in transition care, which negatively impacts patients' outcomes. Since then, an evidence-based guideline and practical toolbox for effective transition of AYA with asthma and allergies have been published. Aims To assess HCPs' perspectives, practice and challenges on transition care for AYA with asthma and allergies, including the impact of the recent guideline, potential differences across countries and changes since 2019. Methods Cross-sectional online survey-based study. European HCP managing AYA with allergies and/or asthma were invited to participate in May–June 2023. Results 511 responses were collected. Amongst respondents, 60%–70% were familiar with the guideline and toolbox, and found them helpful. At least for selected patients, 50%–85% of respondents adhered to some guideline recommendations and initiatives/resources for transition care such as simplifying medication regimes, seeing AYA on their own or producing transition reports. We observed improvements compared to 2019 in areas such as prioritising transition, training, assessment of psychosocial issues and transition readiness, access to other HCP, transfer and post-transfer feedback systems. However, 20% of respondents had no transition process and around 50% had no transition-specific elements. Sixty percent found transition care ‘very’ or ‘moderately challenging’, with transition not being prioritised, time constraints and limited expertise on psychosocial issues as leading problems. Significant differences were observed in transition practice across countries. Conclusion Despite improvement in training and approach towards transition care, challenges and limitations persist in effectively implementing evidence-based guidelines. Raising greater awareness about the need for, and the positive impact of high-quality transition care amongst policy-makers, HCP, and patients/families remains a key priority to unlock resources for training and effective implementation at a national/international level.