Addressing psychological issues (Table 4)
Many AYA with allergy and/or asthma have co-existing psychological issues, including anxiety, depression, suicidal ideation, and relational difficulties.33,57-74 These problems may magnify the complexities of self-management, care coordination and treatment planning in AYA with allergy and/or asthma. Therefore, the identification and management of psychological issues impacting disease control and health-related quality of life can be recommended (Grade B).
It is known that the social context of a person’s life determines the risk of exposure, as well as their susceptibility, the course and outcome of illness.75,76 Socioeconomic factors and stressful life events can impact disease control34,77-81 and HRQL in allergic diseases64,70,82,83. Therefore, the identification and management of socioeconomic issues and stressful life events impacting disease control and HRQL may be recommended (Grade C).
Where AYA are struggling to successfully self-manage their asthma, psychological interventions using a CBT based or multi-systemic therapy approach can be recommended to improve asthma knowledge, improve adherence, self-management and symptom control (Grade B).39-42 This is based on a small number of randomised controlled asthma trials. Similar approaches are likely to be helpful where allergy is the key problem.