Barriers and facilitators to asthma self‐management in adolescents: A systematic review of qualitative and quantitative studies

Abstract

There is a pressing need to prepare adolescents for self-management, using age-appropriate strategies that draw on the evidence we have synthesized. Current clinical practice should focus on ensuring adolescents have the correct knowledge, beliefs, and positive attitude to self-manage their illness. This needs to be delivered in a supportive environment that facilitates two-way communication, fosters adolescents' self-efficacy to manage their disease, and considers the wider social influences that impinge on self-management. Pediatr Pulmonol. 2017;52:430-442. © 2016 Wiley Periodicals, Inc.

Barriers and facilitators to self‐management of asthma in adolescents: An interview study to inform development of a novel intervention

“…Our findings support previous systematic reviews and studies that show treatment adherence are often difficult for adolescents due to forgetting medication (either intentionally or unintentionally), medication being a burden, lack of knowledge about treatments, embarrassment and apathy . We also found support for previous studies that identify other self‐management issues such as the importance of communication between adolescents and HCPs, knowledge about asthma, avoiding triggers, support from family, friends, peers, and school, and anxiety and panic .…”

“…The key themes that emerged were: knowledge, lifestyle influences (such as routines), beliefs and attitudes, relationships with others, intrapersonal characteristics (such as motivation) and communicating with others (such as healthcare professionals). 4 There were, however, methodological limitations of some studies included in this review. There were concerns about the quality of some studies due to inadequate study design, methodology or reporting details; the inclusion of participants outside of the typical adolescent age range (less than 10 or over 18 years of age); and heterogeneity in the study settings (eg hospital clinics and schools).…”

“…We conducted a systematic review and narrative synthesis of literature that included adolescent reported barriers and facilitators to asthma self‐management. The key themes that emerged were: knowledge, lifestyle influences (such as routines), beliefs and attitudes, relationships with others, intrapersonal characteristics (such as motivation) and communicating with others (such as healthcare professionals) . There were, however, methodological limitations of some studies included in this review.…”

They just don't take their medicines: Reframing medication adherence in asthma from frustration to opportunity

“…In addition, children and adolescents with asthma present unique challenges to medication adherence. Adolescents may report erroneous medication beliefs (eg, medications are for when one is sick, “growing out of asthma,”) , poor knowledge, forgetting, lack of routines, hurrying, competing social priorities, difficulties communicating with healthcare providers, poor health literacy, concerns for side effects and social stigma associated with having asthma and using inhalers 41,47–50 . In addition, adolescents may feel that using controller medication may create a dependence 51 .…”

“…Adolescents may report erroneous medication beliefs (eg, medications are for when one is sick, "growing out of asthma,"), poor knowledge, forgetting, lack of routines, hurrying, competing social priorities, difficulties communicating with healthcare providers, poor health literacy, concerns for side effects and social stigma associated with having asthma and using inhalers. 41,[47][48][49][50] In addition, adolescents may feel that using controller medication may create a dependence. 51 Improved necessity beliefs among adolescents with asthma have also been associated with improved self-reported adherence.…”