A transition program for adolescents and young adults with bronchial asthma

Introduction: Health Transition is a process supporting adolescents passing from pediatric to adult care, to acquire autonomy in their health management. Bronchial asthma management need more attention in this phase because of its high prevalence in childhood and different characteristics of the disease in adults and children. Methods: Clinical, biohumoral and functional data of 126 asthmatic patients who started Transition from AOU Meyer to AOU Careggi in 2022-2024 were collected; comorbidities were documented; disease control, quality of life (QoL), therapy adherence, readiness to transition and satisfaction with the health care received were investigated by means of dedicated questionnaire. Results: Clinical control, respiratory function (post bronchodilation FEV1), biohumoral parameters (eosinophil count) improved 6 months after transition. For each year of disease duration and for each point of therapy adherence test, readiness increased by 13% and 11%, respectively. A model considering functional and biohumoral parameters and questionnaire scores explained 15% of the variance in Readiness to transition. Biological therapy (14%) involved male and female patients with same prevalence. They showed a higher hospitalization rate, higher dose of oral corticosteroids and displayed a better Reasdiness and respiratory function when compared to less severe patients. Conclusion: A structured transition program leads to better outcomes in asthma control and quality of life. Among several variables that involved Readiness to transition, adherence to therapy is determinant of readiness itself. A more severe disease and biologic therapy are linked to a better asthma control, lung function and higher readiness to transition.