Transition healthcare for adolescents and young adults with food allergy

Adolescents and young adults (AYA) have the highest risk of death from anaphylaxis to foods, together with quality of life burden, psychological and social challenges. AYA go through a period of profound physical, emotional, cognitive and social change. Bio-psychosocial development means that dimensions relevant to food allergy change rapidly with age and impact the needs, concerns, and type of support needed by the patient and family. For instance, AYA often face multiple new situations that involve food and risk of breakthrough reactions, and require AYA to make complex decisions to keep safe. Although adolescence may be seen as a period of risk, it can also provide opportunities to support healthy behaviors, encourage independence and active decision making. Healthcare professionals (HCP) play a vital role in facilitating AYA's healthcare transition. This involves the crucial process of education and guidance for AYA to achieve effective independent self-management, including accessing the adult-centered healthcare system. AYA's family, peers and the wider community play an important supporting role that should be facilitated. This article provides an overview of the challenges and needs of AYA with food allergy and proposes pragmatic approaches to structuring the healthcare transition process to improve self-management. A range of resources, including high-quality websites and checklists for discussion on preparedness for reaction management, making safe food choices and generic skills, will be presented to facilitate implementation in clinical practice.