Marta Vazquez-Ortiz1, Elizabeth Angier2, Katharina Blumchen3, Pasquale Comberiati4,5, Bettina Duca6, Audrey DunnGalvin7,8, Claudia Gore6,9, Valérie Hox10, Britt Jensen11, Helena Pite12,13, Alexandra F Santos14,15,16,17, Silvia Sanchez18, Cherry Alviani19,20, Teresa Garriga-Baraut21,22, Rebecca Knibb23, Charlotte G Mortz11, M Hazel Gowland24, Frans Timmermans25, Graham Roberts19,20,26. 1. Department of Paediatrics, Faculty of Medicine, Imperial College London, London, UK. 2. Primary Care and Population Sciences, University of Southampton, Southampton, UK. 3. Department of Paediatric and Adolescent Medicine, Paediatric Pneumology, Allergology and Cystic Fibrosis, University Hospital Frankfurt, Frankfurt am Main, Germany. 4. Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. 5. Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Moscow, Russia. 6. Department of Paediatrics, Imperial College London, London, UK. 7. Applied Psychology and Paediatrics and Child Health, University College Cork, Cork, Ireland. 8. Paediatrics and Child Infectious Diseases, First Moscow State Medical University, Moscow, Russia. 9. Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK. 10. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Saint-Luc, Brussels, Belgium. 11. Department of Dermatology and Allergy Centre, Odense Research Centre for Anaphylaxis (ORCA), Odense University Hospital, University of Southern Denmark, Odense, Denmark. 12. Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital, Lisbon, Portugal. 13. CEDOC, Chronic Diseases Research Center, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal. 14. Department of Women and Children's Health (Paediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK. 15. Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK. 16. Children's Allergy Service, Guy's and St Thomas' Hospital, London, UK. 17. Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK. 18. Allergy Department, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain. 19. University of Southampton Faculty of Medicine, Southampton, UK. 20. The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK. 21. Unitat d'Al.lergologia Pediàtrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain. 22. Grup d'Investigació "Creixement i Desenvolupament", Institut de Recerca de l'Hospital Universitari Vall d'Hebron (VHIR), Barcelona, Spain. 23. Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham, UK. 24. Allergy Action, St Albans, UK. 25. Frans Timmermans: Nederlands Anafylaxis Netwerk - European Anaphylaxis Taskforce, Dordrecht, The Netherlands. 26. NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Abstract
BACKGROUND: Adolescence represents a vulnerable time for individuals with asthma and allergic conditions. They suffer an unexpected degree of morbidity. This systematic review aimed to understand the challenges faced by adolescents and young adults with these 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 meta-synthesis was undertaken. RESULTS: A total of 108 papers describing 106 studies were retrieved, most focused on asthma. Five themes were identified across studies: (a) Health-related quality of life-impairment was associated with poor disease control, psychosocial issues, adolescent-onset allergic disease and female sex; (b) Psychological factors-asthma and food allergy were associated with anxiety and depression, atopic dermatitis was associated with suicidal ideation, and that parental emotional support may be protective; (c) Adherence-suboptimal adherence was associated with older age, barriers to medication usage, poor symptom perception and failure to take responsibility, and positive factors were routines, simpler treatment regimes, better knowledge and perceptions about medications; (d) Self-management-facilitated by education, knowledge and a positive attitude; and (e) Supportive relationships-families could modify barriers to adherence and foster positive views about self-management, adolescents suggested that their peers should be more involved in supporting them, and adolescents also wished to have support from nonjudgemental healthcare professionals. CONCLUSIONS: We have some understanding of the challenges faced by adolescents with asthma, less so for other allergic conditions. This knowledge will be used to support guidelines for managing adolescents.
BACKGROUND: Adolescence represents a vulnerable time for individuals with asthma and allergic conditions. They suffer an unexpected degree of morbidity. This systematic review aimed to understand the challenges faced by adolescents and young adults with these 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 meta-synthesis was undertaken. RESULTS: A total of 108 papers describing 106 studies were retrieved, most focused on asthma. Five themes were identified across studies: (a) Health-related quality of life-impairment was associated with poor disease control, psychosocial issues, adolescent-onset allergic disease and female sex; (b) Psychological factors-asthma and food allergy were associated with anxiety and depression, atopic dermatitis was associated with suicidal ideation, and that parental emotional support may be protective; (c) Adherence-suboptimal adherence was associated with older age, barriers to medication usage, poor symptom perception and failure to take responsibility, and positive factors were routines, simpler treatment regimes, better knowledge and perceptions about medications; (d) Self-management-facilitated by education, knowledge and a positive attitude; and (e) Supportive relationships-families could modify barriers to adherence and foster positive views about self-management, adolescents suggested that their peers should be more involved in supporting them, and adolescents also wished to have support from nonjudgemental healthcare professionals. CONCLUSIONS: We have some understanding of the challenges faced by adolescents with asthma, less so for other allergic conditions. This knowledge will be used to support guidelines for managing adolescents.
Authors: Ekaterina Khaleva; Marta Vazquez-Ortiz; Pasquale Comberiati; Audrey DunnGalvin; Helena Pite; Katharina Blumchen; Teresa Garriga-Baraut; Valerie Hox; Alexandra F Santos; Claudia Gore; Rebecca C Knibb; Cherry Alviani; Charlotte G Mortz; Elizabeth Angier; Bettina Duca; Britt Jensen; Silvia Sanchez-Garcia; M Hazel Gowland; Frans Timmermans; Oliver Pfaar; Graham Roberts Journal: Clin Transl Allergy Date: 2020-10-07 Impact factor: 5.871