Many adolescents with asthma inadequately prepared for transition to adult care

Most adolescents and young adults with asthma were not sufficiently prepared for the transition from their pediatric to adult asthma providers, according to study results.

The results, presented at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting, also showed that many undergraduate students had no asthma provider at all, underscoring the importance of establishing a transition plan prior to starting college, according to the researchers.

“Teens who are about to go off to college are at an ideal stage to discuss transition issues,” William Anderson, MD, associate program director of allergy and immunology fellowship and co-director of the Multidisciplinary Asthma Clinic at University of Colorado and Children's Hospital Colorado, said in a press release. “They are entering a new era, possibly in a different part of the country, and may be making their own health care decisions for the first time. Introducing concepts about self-care in terms of what will be changing in their lives and what they need to take responsibility for can help them control their asthma symptoms as they begin their journey into adulthood.”

Anderson and colleagues surveyed 46 patients with asthma aged 18 to 30 years regarding their experiences with transition planning while receiving pediatric care. Of them, 19 were previously treated at a tertiary care pediatric hospital (hospital cohort) and 27 were currently students or staff of a university system (university cohort). Those in the former cohort reported receiving their asthma care from a specialist, whereas most of those in the university cohort received asthma care from a general provider.

Around half (56.7%) of all respondents reporting receiving no information on concepts of transitioning care, including about asthma self-management, by their pediatric asthma provider. Only 17.4% reported they had received information on transferring their care to an adult provider.

A significantly greater proportion of those from the hospital cohort reported that their pediatric asthma doctor had asked if they could explain asthma (78.9% vs. 33.3%) and taught them how to manage asthma exacerbations (94.7% vs. 55.6%; P .01 for both).

Also, a greater proportion of those from the hospital cohort had not established care with an adult asthma provider than those in the university cohort (63.2% vs. 18.5%; P = .0045).

Further, significantly more participants from the hospital cohort who did not currently have an asthma provider reported “some college” as their highest level of education achieved (P = .0198).

Common barriers to transfer of care including difficulties navigating the health care system, insufficient information for transition, not used to managing their own health, financial problems and uncomfortable with getting a new doctor.

Based on these findings, the researchers identified areas for improvement, recommending that concepts of transition are introduced before the age of 14 years, information is provided about the adult provider for transfer, and there is greater assistance in navigating the health care system.

“Of those we surveyed, most participants did not receive sufficient transition preparation from their pediatric asthma providers, no matter who was providing their asthma care,” Suzanne Ngo, MD, instructor in medicine-allergy/clinical immunology at University of Colorado School of Medicine, said in the release.

Reference:

• Most young people with asthma haven't been prepared to transition to adult asthma care. https://annualmeeting.acaai.org/2021/most-young-people.cfm. Published Nov. 4, 2021. Accessed Nov. 5, 2021.