Identification and management of psychological issues impacting disease control and health related quality of life can be recommended (Grade B, Evidence level II-III) Identification and management of psychological issues impacting disease control and health related quality of life can be recommended (Grade B, Evidence level II-III) Identification and management of psychological issues impacting disease control and health related quality of life can be recommended (Grade B, Evidence level II-III)
Strength of recommendation: Moderate recommendation based on low risk of bias in quantitative cross-sectional57,62,63,65-73 and quantitative cohort studies64. These included AYA with asthma57,62-64,68,71-73, atopic dermatitis65-67,69 and food allergy70. Other considerations: Many AYA with asthma and allergy have associated psychological issues. Tools such as HEADSS26 or YouthCHAT84,85may be helpful in identifying problems that can then be addressed and managed85 in an appropriate way. References: Bruzzese57,Bruzzese72,73, Ferro64; Halvorsen65, Kim66,Lee67,Lu68, Noh69,Polloni70, Shankar71,Hullmann63.
Identification and management of socioeconomic issues and stressful life events impacting disease control and health related quality of life may be recommended (Grade C, Evidence level II-IV) Identification and management of socioeconomic issues and stressful life events impacting disease control and health related quality of life may be recommended (Grade C, Evidence level II-IV) Identification and management of socioeconomic issues and stressful life events impacting disease control and health related quality of life may be recommended (Grade C, Evidence level II-IV)
Strength of recommendation: Moderate recommendation based on low risk of bias in quantitative cross-sectional 69,81,82, quantitative cohort64,79 and quantitative case series studies83. AYA had asthma79,81-83, atopic dermatitis69 and food allergy64. Other considerations: Examples include factors that may impact on quality of life including divorce, bankruptcy, bereavement and recent severe allergic reactions.69,82,83 Potential financial barriers should be explored in young adults. These areas need to be explored in a sensitive way. References: Ferro64,Hedman82,Amaral83,Noh69,Stridsman81,Sundell79.
Psychological interventions using a cognitive behavioural therapy based or multi-systemic therapy approach can be recommended to improve adherence, asthma knowledge, self-management and symptom control (Grade B, Evidence level I) Psychological interventions using a cognitive behavioural therapy based or multi-systemic therapy approach can be recommended to improve adherence, asthma knowledge, self-management and symptom control (Grade B, Evidence level I) Psychological interventions using a cognitive behavioural therapy based or multi-systemic therapy approach can be recommended to improve adherence, asthma knowledge, self-management and symptom control (Grade B, Evidence level I)
Strength of recommendation: Moderate recommendation due to specific population39,41,42 based on low to intermediate risk of bias in one randomized controlled trial39,41,42,66and a randomized pilot trial40. Psychological interventions can be considered for AYA who are struggling to successfully self-manage their asthma. Other considerations: Evidence for asthma knowledge, self-management and symptom control, mainly involving African American AYA with asthma in one study39,41,42. It is possible that findings may be extrapolated to other conditions. However, more studies are needed. These interventions are likely to be most effective for specific patients, for example those struggling to self-manage. The active involvement of the AYA is essential for success. The psychologist should have a good understanding of allergy and asthma. References: Naar41, Ellis39, Naar-King42, Bruzzese40.