Written asthma action plans

• Published in: Thorax 2004-02, Vol.59 (2), p.87-88
• Main Author: Partridge, M R
• Format: Article
• Language: English
• Subjects: Adult; Asthma; Asthma - therapy; asthma action plan; Child; Education; Emergency medical care; Health care; Hospitals; Humans; Medical personnel; Patient Care Planning; Practice Guidelines as Topic; Self Care; Teaching
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thx.2003.016451

1 Similar advice has been repeated in subsequent revisions of the UK guidelines 2- 4 and in the NHLBI global strategy for asthma management and prevention. 5 The evidence base for these recommendations is strong, and 36 trials comparing self-management education with usual care were reviewed for the Cochrane Library. 6 This review suggested that self-management education could be associated with a reduction in hospital admissions of up to 40%, a reduction in emergency room visits of 20%, and similarly impressive reductions in unscheduled visits to the doctor, night time symptoms, and days off work or school. An Italian study suggested that the most efficacious interventions were probably those which involved reducing the dose of inhaled steroid when well controlled and then quadrupling it at the first sign of loss of control of asthma. 16 The need for us to teach patients how to both increase and decrease their dose of inhaled steroids is exemplified by recent work which showed that, in a group of adults with asthma, the active practice of stepping down treatment was associated with a mean reduction in daily inhaled steroid usage of 348 [mu]g beclomethasone equivalent per day, with equally good outcomes to those who had stayed on a fixed dose. 17 Patients with many long term conditions fail to comply with their therapeutic regimen.