Atzert N, Gore C, Knibb R C, Alviani C, Angier E, Blumchen K, Comberiati P, Duca B, DunnGalvin A, Garriga-Baraut T, Gowland M H, Egmose B, Khaleva E, Mortz C G, Pite H, Pfaar O, Podesta M, Sanchez Garcia S, Santos A F, Roberts G, Vazquez Ortiz M
Department of Allergy and Clinical Immunology, Kinderspital Zurich, Zurich, Switzerland.
Department of Paediatric Allergy, Imperial College Healthcare NHS Trust, London, UK.
Allergy. 2025 Jun;80(6):1592-1612. doi: 10.1111/all.16603. Epub 2025 Jun 17.
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.
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.
Cross-sectional online survey-based study. European HCP managing AYA with allergies and/or asthma were invited to participate in May-June 2023.
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.
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.
患有哮喘和过敏症的青少年及青年（AYA）的死亡率和发病率意外地高。2019年在欧洲医疗保健专业人员（HCP）中进行的一项调查凸显了过渡护理方面的重大差距，这对患者的治疗结果产生了负面影响。从那时起，已发布了一份关于患有哮喘和过敏症的AYA有效过渡的循证指南和实用工具箱。
评估HCP对患有哮喘和过敏症的AYA过渡护理的看法、实践和挑战，包括近期指南的影响、各国之间的潜在差异以及自2019年以来的变化。
基于在线横断面调查的研究。2023年5月至6月，邀请管理患有过敏症和/或哮喘的AYA的欧洲HCP参与。
共收集到511份回复。在受访者中，60%-70%熟悉该指南和工具箱，并认为它们很有帮助。至少对于部分患者，50%-85%的受访者遵循了一些指南建议以及过渡护理的倡议/资源，如简化用药方案、单独诊治AYA或生成过渡报告。与2019年相比，我们观察到在一些方面有所改善，如过渡的优先级、培训、心理社会问题评估和过渡准备情况、接触其他HCP、转诊及转诊后反馈系统等。然而，20%的受访者没有过渡流程，约50%没有特定的过渡要素。60%的人认为过渡护理“非常”或“有一定挑战性”，过渡未被列为优先事项、时间限制以及心理社会问题方面的专业知识有限是主要问题。各国在过渡实践方面存在显著差异。
尽管在过渡护理的培训和方法上有所改进，但在有效实施循证指南方面，挑战和限制仍然存在。提高政策制定者、HCP以及患者/家庭对高质量过渡护理的必要性及其积极影响的认识，仍然是在国家/国际层面释放培训和有效实施资源的关键优先事项。
