Transition from child to adult asthma care

The idea behind transition is to help you feel confident and ready to take charge of your own asthma by the time you move to adult care.

You might have been looking after your own asthma for some time, as a child and young teenager. You may be wondering what all the fuss is about, especially if you've only ever seen your GP or asthma nurse for your asthma care.

Or you might feel worried and upset about moving from the paediatric clinic you've been used to into a new adult clinic with new consultants to get to know.

However you're feeling, this page has lots of information to help you know what to expect.

What is transition?

Transition is when your healthcare team supports you in getting ready to move from children's healthcare to adult healthcare. A good transition plan gives you plenty of time to prepare before you eventually transfer. 

Who goes through transition?

If you see a consultant paediatrician in an asthma clinic about your asthma, you might go through a formal transition process. This is to support your move into adult services when you're old enough.

If you only see your GP or asthma nurse about your asthma you won’t go through transition as you would in an asthma clinic or hospital setting. 

But at some point you’ll be included more in the conversations about your asthma. And you’ll be asked to take more responsibility. This will mean understanding your medicines and using your written asthma action plan.

Once you’re 16, you can start seeing your GP or asthma nurse on your own, without your parents or carers, if you want.

When is transition?

Ideally, your paediatric team will start to talk to you about transition when you’re about 14. But this age isn’t set in stone. The exact timing varies from person to person.

You’ll have conversations with your consultant, GP or asthma nurse about how to get ready for the adult asthma clinics.

Most people move into adult services at the age of 16 or 18.

Who’s involved in transition?

You, your family or carers, your paediatrician and asthma nurse are all involved in your transition. Together you can plan for your move to an adult asthma clinic, including the timings for it.

You can take into account other things that might be going on for you, such as exams or holidays.

You might have a ‘key worker’ or ‘transition co-ordinator’ to oversee your transition so you and your family have one point of contact.

All clinics and hospitals do things differently. But a good transition care plan will include information on who to contact if you need support or advice. It will also explain how your appointments will work.

What’s the difference between children and adult asthma services? 

Adult care settings are different to children’s. You’ll probably notice there’s less focus on family involvement and more on you as an individual looking after your own asthma.

As experts in adult asthma, your new team will know all about the issues you may come across as a young adult.

What about my parents/carers?

Try not to forget your parents or carers! They’ve been used to looking after you and your asthma, possibly for many years. It might not be easy for them to let go and trust that you can look after yourself now.

It may be especially hard for them if your asthma’s affected you a lot and you’ve needed to go into hospital several times during your childhood.

Talk to them about how you’re managing your asthma so they feel more confident that you're doing all the right things to stay well. At first, you may want to include them in your appointments so they have a chance to ask their own questions.

You could let them have an updated copy of your written asthma action plan so they know what – if anything – has changed.

Your checklist - questions you might like to ask your doctor or asthma nurse:

  • At what age will I move to adult services?
  • What asthma clinic or hospital will I move to?
  • Is there a transition care package?
  • Will my new team have all my medical records?
  • Will I have a key worker or transition coordinator to oversee my transition?
  • Is it possible to arrange a visit to the adult asthma clinic to meet the team and find out where appointments are held before I move my care there?
  • Can we run through all my asthma medicines to check I’m taking them correctly?
  • Can you check my inhaler technique?
  • Is there a way I can remember to take all my medicines every day?
  • What can I do to make sure I keep track of all my appointments?

For parents and carers of children with asthma

Transition can be a worrying time for parents and carers. You may be concerned about how your child will manage their asthma, and how they’ll cope with moving to a new asthma clinic.

You might worry about whether they’ll take in what they’re told during appointments. And you might find it difficult to feel you’re losing control and are no longer in charge of your child’s healthcare.

This may be especially hard if your child’s asthma has been difficult to manage and they’ve been in hospital during their childhood.

It’s natural to have these concerns – but worrying too much may make the transition process more stressful for both you and your child. We have some answers to common questions:

How can I help make the move to adult asthma services easier for my child?

You could start by letting your child have some control over their health before they officially move to adult services.

For example, before their next appointment, you could sit down with them and plan one or two questions they could ask the GP or asthma nurse themselves.

You could also ask the GP, doctor or asthma nurse to speak directly to your child, rather than to you, to help them feel as though they’re in control of the appointment.

How can I help them remember to take their inhalers?

One of the best ways to help your child get into a routine is to make it part of something they do already. For example, if they have to take a preventer inhaler twice a day, you could encourage them to use it just before they’ve brushed their teeth in the morning and evening. 

Encourage your child to check they've got their reliever inhaler with them when they go out, just as they might check they've got their keys or travel pass. You could put a reminder on the front door for a while to help them fix it into their memory.

What can I do if they’re not taking their asthma medicine as prescribed?

If your child finds it hard to take their inhalers and any other medicine, talk to them about what gets in the way.

Are they avoiding taking their inhalers because they don't want to accept they have asthma? Or maybe they aren’t very organised and simply forget.

Encourage them to think about what stops them and what might help, so you can come up with solutions.

For example, if taking asthma medicine every day makes them feel different to their friends, remind them that lots of young people have medical conditions they deal with. Help them understand that taking their preventer inhaler as prescribed is the best way to stop asthma symptoms, so they can get on with doing all the things they want to do.

If they keep forgetting, you could sit down together and think of ways to help them remember – perhaps they could download a reminder app onto their phone.

If you’re not sure how to help them or need more ideas, speak to their GP, asthma nurse or a pharmacist. Or give our Helpline nurses a call.

How can I stay involved in their asthma care?

During the transition process, you could arrange an appointment with your child’s new team, so you can meet everyone who'll be involved before they move to adult services.

After this you can still go to some appointments with them, if your child is happy with that. If they prefer to go on their own, encourage them to make a list of questions they want to ask, and go through this with them before the appointment.

You could also set aside ten minutes for a ‘debrief’, when they tell you what happened in the appointment.

However, remember your child might like feeling independent. And they might feel more confident about looking after themselves, if you can show you’re confident in them.

How can the whole family be supportive?

Even if your child enjoys their independence and wants to manage their asthma on their own, it can be helpful to them to feel the family is still involved.

You could encourage your child to keep a copy of their written asthma action plan where the whole family can see it – for example, on the fridge door.

This means you will all know the signs that suggest your child’s asthma may be getting worse, and you’ll all know their triggers. It can help them feel supported, and remind them they’re not managing on their own.

Don't forget, if you're worried about your child's asthma you can call our friendly asthma nurses on 0300 222 5800, 9am-5pm, Mon-Fri.

Last updated February 2018

Next review due July 2019