The role of written action plans in childhood asthma

Current Opinion in Allergy and Clinical Immunology

Volumn 8, Issue 2, 2008, Pages 177-188

  Ducharme, Francine M ^a   Bhogal, Sanjit K ^b  

^a MONTREAL CHILDREN S HOSPITAL   (Canada)

^b MCGILL UNIVERSITY   (Canada)

Author keywords

Asthma; Children; Self management; Written action plan

Indexed keywords

BETA ADRENERGIC RECEPTOR STIMULATING AGENT; BRONCHODILATING AGENT; SALBUTAMOL; STEROID; TERBUTALINE;

ASTHMA; CLINICAL TRIAL; CONTROLLED RELEASE FORMULATION; DISEASE EXACERBATION; DRUG MEGADOSE; HEALTH CARE PERSONNEL; HEALTH EDUCATION; HUMAN; NEBULIZER; PEAK EXPIRATORY FLOW; PEDIATRICS; PRACTICE GUIDELINE; PRIORITY JOURNAL; REVIEW; SELF CARE; TREATMENT OUTCOME; TREATMENT PLANNING; VALIDATION STUDY;

ADOLESCENT; ANTI-ASTHMATIC AGENTS; ASTHMA; CHILD; CHILD, PRESCHOOL; CLINICAL TRIALS AS TOPIC; COMPREHENSIVE HEALTH CARE; COMPUTER-ASSISTED INSTRUCTION; HEALTH PLANNING; HUMANS; OUTCOME AND PROCESS ASSESSMENT (HEALTH CARE); PATIENT CARE PLANNING; PATIENT COMPLIANCE; PATIENT EDUCATION AS TOPIC; SELF CARE; TREATMENT OUTCOME;

EID: 43249129601     PISSN: 15284050     EISSN: 14736322     Source Type: Journal    
DOI: 10.1097/ACI.0b013e3282f7cd58     Document Type: Review

References (89)

1. Global Initiative for Asthma. Global strategy for asthma management and prevention [updated 2007]. www.ginasthma.org. [Accessed 11 December 2007]
2. Gibson PG, Powell H, Coughlan J, et al. Self-management education and regular practitioner review for adults with asthma. Cochrane Database Syst Rev 2002; (3):CD001117.
3. Guevara JP, Wolf FM, Grum CM, Clark NM. Effects of educational interventions for self management of asthma in children and adolescents: systematic review and meta-analysis. BMJ 2003; 326:1308-1309.
4. Anonymous. Asthma Management Handbook 2002. 5th ed. Melbourne: National Asthma Campaign; 2002.
5. British Thoracic Society. British guidelines on the management of asthma. London: British Thoracic Society; 2005.
6. Lemiere C, Bai T, Balter M, et al. Adult asthma guidelines update 2003. Can Respir J 2004; 11:9A-18A.
7. National Asthma Education and Prevention Program. NAEEP Expert Panel Report. Bethesda: NAEPP; 2008.
8. Global asthma physician and patient (GAPP) survey. 2005. http://www.gappsurvey.org/media-key-findings.html. [Accessed 22 January 2008]
9. Sheares BJ, Du Y, Vazquez TL, et al. Use of written treatment plans for asthma by specialist physicians. Pediatr Pulm 2007; 42:348-356.
10. Partridge MR. Written asthma action plans. Thorax 2004; 59:87-88.
11. Fitzgerald JM, Boulet LP, McIvor RA, et al. Asthma control in Canada remains suboptimal: the reality of asthma control (TRAC) study. Can Respir J 2006; 13:253-259.
12. Ruffin RE, Wilson D, Southcott AM, et al. A South Australian population survey of the ownership of asthma action plans. Med J Aust 1999; 171:348-351.
13. McNally AJ, Frampton C, Garrett J, Pattemore P. Application of asthma action plans to childhood asthma: national survey repeated. N Z Med J 2004; 117:U932.
14. Ly CD, Dennehy CE. Emergency department management of pediatric asthma at a university teaching hospital. Ann Pharmacother 2007; 41:1625-1631.
15. Cote J, Bowie DM, Robichaud P, et al. Evaluation of two different educational interventions for adult patients consulting with an acute asthma exacerbation. Am J Respir Crit Care Med 2001; 163:1415-1419.
16. Kauppinen R, Sintonen H, Tukiainen H. One-year economic evaluation of intensive vs conventional patient education and supervision for self-management of new asthmatic patients. Respir Med 1998; 92:300-307.
17. Lefevre F, Piper M, Weiss K, et al. Do written action plans improve patient outcomes in asthma? An evidence-based analysis. J Fam Prac 2002; 51:842-848.
18. Baldwin DR, Pathak UA, King R, et al. Outcome of asthmatics attending asthma clinics utilising self-management plans in general practice. Asthma in General Practice 1997; 5:31-32.
19. Beauchesne MF, Levert V, El TM, et al. Action plans in asthma. Can Respir J 2006; 13:306-310.
20. Moffat M, Cleland J, van der Molen T, Price D. Poor communication may impair optimal asthma care: a qualitative study. Fam Pract 2007; 24:65-70. Using qualitative research methods, this study examined healthcare professionals' views towards asthma guidelines and self-management plans. Mainly, healthcare providers had positive attitudes towards guidelines and self-management plans when deemed suitable by the individual. Healthcare professionals, however, reported lacking necessary communication skills for dealing with patient asthma control issues. Poor professional-patient communication accounts for much of the poor uptake of self-management plans and guideline use in general practice and primary care.
21. Zemek R, Bhogal SK, Ducharme FM. What's the plan? A systematic review of randomised controlled trials examining written action plans in children. Arch Dis Child (in press).
22. Toelle BG, Ram FS. Written individualised management plans for asthma in children and adults. Cochrane Database Syst Rev 2002; (3):CD002171.
23. Cowie RL, Revitt SG, Underwood MF, Field SK. The effect of a peak flow-based action plan in the prevention of exacerbations of asthma. Chest 1997; 112:1534-1538.
24. Jones KP, Mullee MA, Middleton M, et al. Peak flow based asthma self-management: a randomised controlled study in general practice. British Thoracic Society Research Committee. Thorax 1995; 50:851-857.
25. van der Palen J, Klein JJ, Zielhuis GA, et al. Behavioural effect of self-treatment guidelines in a self-management program for adults with asthma. Patient Educ Couns 2001; 43:161-169.
26. Agrawal SK, Singh M, Mathew JL, Malhi P. Efficacy of an individualized written home-management plan in the control of moderate persistent asthma: a randomized, controlled trial. Acta Paediatr 2005; 94:1742-1746.
27. Ducharme FM, Zemek R, Chalut D, et al. Does the use of a new written action plan increase short-term adherence to prescribed medication and asthma control in children treated for an asthma attack in the emergency department: a randomized controlled trial. www clinicaltrial gov [updated 2008]. http://clinicaltrials.gov/ct2/show/NCT00381355?term= written+action+plan+AND+asthma&rank=1. [Accessed 22 January 2008]
28. Bush A. Phenotype specific treatment of asthma in childhood. Paediatr Respir Rev 2004; 5 (Suppl A):S93-S101.
29. Adams NP, Bestall JC, Jones PW, et al. Inhaled fluticasone at different doses for chronic asthma in adults and children. Cochrane Database Syst Rev 2005; (3):CD003534.
30. Adams NP, Bestall JC, Lasserson TJ, et al. Fluticasone versus placebo for chronic asthma in adults and children. Cochrane Database Syst Rev 2005; (4):CD003135.
31. Ducharme FM, Di Salvio F. Antileukotriene agents compared to inhaled corticosteroids in the management of recurrent and/or chronic asthma in adults and children. Cochrane Database of Systematic Reviews 2004; (1):CD002314.
32. Walters EH, Walters J. Inhaled short acting beta2-agonist use in chronic asthma: regular versus as needed treatment. Cochrane Database Syst Rev 2003; (2):CD001285.
33. Cates CJ, Crilly JA, Rowe BH. Holding chambers (spacers) versus nebulisers for beta-agonist treatment of acute asthma. Cochrane Database Syst Rev 2006; (2):CD000052.
34. Fitzgerald JM, Becker A, Sears MR, et al. Doubling the dose of budesonide versus maintenance treatment in asthma exacerbations. Thorax 2004; 59:550-556.
35. Garrett J, Williams S, Wong C, Holdaway D. Treatment of acute asthmatic exacerbations with an increased dose of inhaled steroid. Arch Dis Child 1998; 79:12-17.
36. Volovitz B, Nussinovitch M, Finkelstein Y, et al. Effectiveness of inhaled corticosteroids in controlling acute asthma exacerbations in children at home. Clinical Pediatrics 2001; 40:79-86.
37. Fitzgerald JM, Sears MR, Boulet LP, et al. Adjustable maintenance dosing with budesonide/formoterol reduces asthma exacerbations compared with traditional fixed dosing: A five-month multicentre Canadian study. Can Respir J 2003; 10:427-434.
38. Gibson PG, Powell H. Written action plans for asthma: an evidence-based review of the key components. Thorax 2004; 59:94-99.
39. Brunette MG, Lands L, Thibodeau L-P. Childhood asthma: prevention of attacks with short-term corticosteroid treatment of upper respiratory tract infection. Pediatrics 1988; 81:624-629.
40. Harris JB, Weinberger MM, Nassif E, et al. Early intervention with short courses of prednisone to prevent progression of asthma in ambulatory patients incompletely responsive to bronchodilators. J Pediatr 1987; 110:627-633.
41. Oommen A, Lambert PC, Grigg J. Efficacy of a short course of parent-initiated oral prednisolone for viral wheeze in children aged 1-5 years: randomized controlled trial. Lancet 2003; 362:1433-1438.
42. Silk HJ, Guay-Woodford L, Perez-Atayde AR, et al. Fatal varicella in steroid-dependent asthma. J Allergy Clin Immunol 1988; 81:47-51.
43. Kasper WJ, Howe Pm. Fatal varicella after a single course of corticosteroids. Pediatr Infect Dis J 1990; 9:729-732.
44. Patel H, Macarthur C, Johnson D. Recent corticosteroid use and the risk of complicated varicella in otherwise immunocompetent children. Arch Pediatr Adolesc Med 1996; 150:409-414.
45. Dowell SF, Bresee JS. Severe varicella associated with steroid use. Pediatrics 1993; 92:223-228.
46. Stevens CA, Wesseldine LJ, Couriel JM, et al. Parental education and guided self-management of asthma and wheezing in the preschool child: a randomised controlled trial. Thorax 2002; 57:39-44.
47. Warman KL, Silver EJ, McCourt MP, Stein RE. How does home management of asthma exacerbations by parents of inner-city children differ from NHLBI guideline recommendations? Pediatrics 1999; 103:422-427.
48. Bhogal S, Zemek R, Ducharme FM. Written action plans for asthma in children. Cochrane Database Syst Rev 2006; (3):CD005306. This review examines the net impact of providing a written action plan to children with asthma and their children. Based on four clinical trials with 355 children, symptom-based WAPs were compared to peak flow-based WAPs with all other co-interventions were similar. This meta-analysis details several implications for practice, and proposes implications for research to further assess the efficacy of WAPs. To date, this is the first systematic review of randomized controlled trials to examine the efficacy of WAPs in the pediatric population only.
49. Charlton I, Charlton G, Broomfield J, Mullee MA. Evaluation of peak flow and symptoms only self management plans for control of asthma in general practice. BMJ 1990; 301:1355-1359.
50. Letz KL, Schlie AR, Smits WL. A randomized trial comparing peak expiratory flow versus symptom self-management plans for children with persistent asthma. Pediatric Asthma Allergy and Immunology 2004; 17:177-190.
51. Wensley D, Silverman M. Peak flow monitoring for guided self-management in childhood asthma: a randomized controlled trial. Am J Respir Crit Care Med 2004; 170:606-612.
52. Yoos HL, Kitzman H, McMullen A, et al. Symptom monitoring in childhood asthma: a randomized clinical trial comparing peak expiratory flow rate with symptom monitoring. Ann Allerg Asthma Immunol 2002; 88:283-291.
53. Asthma Action Plan. Asthma Society of Canada [updated 2008]. http://www.asthma.ca/adults/control/pdf/AsthmaActionPlan_ENG.pdf. [Accessed 22 January 2008]
54. Asthma Emergency Action Plan for Children Under 5. Asthma New Zealand Lung Association. [updated 2008]; http://www.asthma-nz.org.nz/downloads.aspx. [Accessed 23 January 2008]
55. Under 5s Action Plan. Asthma UK [updated 2008]. http://www.asthma.org.uk/ document.rm?id=203. [Accessed 22 January 2008]
56. Action Plan for Asthma. Conseil du Médicament, Government of Quebec [updated 2008]. http://www.cdm.gouv.qc.ca/site/download.php?f= 001acecabc2093e7efd8cb34e6772f2c. [Accessed 23 January 2008]
57. Action Plan for Asthma Attacks. Conseil du Médicament, Government of Quebec [updated 2008]; http://www.cdm.gouv.qc.ca. [Accessed 22 January 2008]
58. Asthma Action Plan. National Institutes of Health (NIH) [updated 2008]. http://www.nhlbi.nih.gov/health/public/lung/asthma/actionplan_text.htm. [Accessed 22 January 2008]
59. My Asthma Action Plan. Australian Government [updated 2008]. http://www.asthmansw.org.au/assets/146/File/Asthma_Action_Plan_2007(1).pdf. [Accessed 22 January 2008]
60. NAC Asthma Action Plan. National Asthma Council Australia Ltd [updated 2008]. http://www.nationalasthma.org.au/HTML/management/action_plans/print/ aap_Sept2007.pdf. [Accessed 22 January 2008]
61. Spencer Gulf Rural Health School, Pika Wiya Health Service and Asthma SA, as part of an Indigenous Asthma Innovative Management. Every day asthma [updated 2008]. http://www.nationalasthma.org.au/HTML/management/action_plans/ print/everyday_aap2007.pdf. [Accessed 22 January 2008]
62. Family Physician Airway Group. Asthma action plan [updated 2008]. http://www.asthmaguidelines.com/patient_tools.html. [Accessed 22 January 2008]
63. American Academy of Family Physicians. Asthma action plan [updated 2008]; http://familydoctor.org/online/etc/medialib/famdoc/docs/asthma.Par.0001.-File. dat/asthma_AdultActionPlan.pdf. [Accessed 22 January 2008]
64. American Lung Association. Asthma action plan [updated 2008]; http://www.lungusa.org/atf/cf/%7B7A8D42C2-FCCA-4604-8ADE-7F5D5E762256%7D/AAP. PDF. [Accessed 22 January 2008]
65. Symbicort SMART Action Plan (Symptom-based). Symbicort [updated 2008]. http://www.nationalasthma.org.au/HTML/management/action_plans/print/ SMART_aapsymptom.pdf. [Accessed 22 January 2008]
66. Symbicort SMART Action Plan (Peak-flow based). Symbicort [updated 2008]. http://www.nationalasthma.org.au/HTML/management/action_plans/print/ SMART_aapPEF.pdf. [Accessed 22 January 2008]
67. Milnes LJ, Callery P. The adaptation of written self-management plans for children with asthma. J Adv Nurs 2003; 41:444-453.
68. Ducharme F, Noya F, McGillivray D, et al. Two for one: a self-management plan coupled with a prescription sheet for children and adults with asthma. Can Respir J (in press).
69. Feuillet-Dassonval C, Gagnayre R, Rossignol B, et al. Written asthma action plans: a useful tool for self-management. Arch Pediatr 2005; 12:1788-1796.
70. Bibb SC, Norwood R, Meyer JF. Factors associated with healthcare professionals' choice of written asthma management plans. Mil Med 2007; 172:1058-1064. This descriptive study examined the factors associated with healthcare professional's choice of WAP. Healthcare professionals prefer WAP that included pictures, are readability, user-friendly and simple. These are factors that should be considered when creating WAP to increase dispensing of the plan.
71. Adams CD. Relative effectiveness of pictorial and written asthma action plans for pediatric asthma. www clinicaltrial gov [updated 2008]. http://clinicaltrials.gov/ct2/show/NCT00136305?term=asthma+action+plan&rank= 1. [Accessed 22 January 2008]
72. Norton SP, Pusic MV, Taha F, et al. Effect of a clinical pathway on the hospitalisation rates of children with asthma: a prospective study. Arch Dis Child 2007; 92:60-66.
73. Thomson O'Brien MA, Oxman AD, Davis DA, Haynes RB, Freemantle N, Harvey EL. Educational outreach visits: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev 2000; (2):CD000409.
74. Davis RS, Bukstein DA, Luskin AT, et al. Changing physician prescribing patterns through problem-based learning: an interactive, teleconference case-based education program and review of problem-based learning. Ann Allergy Asthma Immunol 2004; 93:237-242.
75. Doherty SR, Jones PD. Use of an evidence-based implementation strategy to implement evidence-based care of asthma into rural district hospital emergency departments. Rural Remote Health 2006; 6:529.
76. Lougheed MD, Moosa D, Finlayson S, et al. Impacts of a provincial asthma guidelines continuing medical education project: The Ontario Asthma Plan of Action's Provider Education in Asthma Care Project. Can Respir J 2007; 14:111-117. This study evaluated baseline knowledge, preferred learning format and satisfaction with a comprehensive educational program to improve the management of adult asthma in the emergency room setting. During the continuing education workshop, healthcare professions identified several important needs, including the development of written action plans. On the postreflective evaluations, reported use of WAPs increased. This study suggested that continuing education should be considered in dissemination and implementation initiatives. A follow-up study on practice and health outcomes is ongoing.
77. Clark NM, Gong M, Schork MA, et al. Long-term effects of asthma education for physicians on patient satisfaction and use of health services. Eur Respir J 2000; 16:15-21.
78. Halterman JS, Fisher S, Conn KM, et al. Improved preventive care for asthma: a randomized trial of clinician prompting in pediatric offices. Arch Pediatr Adolesc Med 2006; 160:1018-1025.
79. Boychuk RB, Demesa CJ, Kiyabu KM, et al. Change in approach and delivery of medical care in children with asthma: results from a multicenter emergency department educational asthma management program. Pediatrics 2006; 117:S145-S151.
80. Haby MM, Waters E, Robertson CF, et al. Interventions for educating children who have attended the emergency room for asthma. Cochrane Database Syst Rev 2001; (1):CD001290.
81. Wesseldine LJ, McCarthy P, Silverman M. Structured discharge procedure for children admitted to hospital with acute asthma: a randomised controlled trial of nursing practice. Arch Dis Child 1999; 80:110-114.
82. Madge P, McColl J, Paton J. Impact of a nurse-led home management training programme in children admitted to hospital with acute asthma: a randomised controlled study. Thorax 1997; 52:223-228.
83. Garrett J, Fenwick JM, Taylor G, et al. Prospective controlled evaluation of the effect of a community based asthma education centre in a multiracial working class neighbourhood. Thorax 1994; 49:976-983.
84. Charlton I, Antoniou AG, Atkinson J, et al. Asthma at the interface: bridging the gap between general practice and a district general hospital. Arch Dis Child 1994; 70:313-318.
85. Mitchell EA, Ferguson V, Norwood M. Asthma education by community child health nurses. Arch Dis Child 1986; 61:1184-1189.
86. Cornman DH. Asthma focus group report: School nurses. Hartford: City of Hartford Health Department; 2001.
87. McLaughlin T, Maljanian R, Kornblum R, et al. Evaluating the availability and use of asthma action plans for school-based asthma care: a case study in Hartford, Connecticut. J Sch Health 2006; 76:325-328.
88. O'Keefe EB. Asthma management in schools: Report of physician focus group and key informant interviews. Hartford: City of Hartford Health Department; 2003.
89. Gerald LB, Redden D, Wittich AR, et al. Outcomes for a comprehensive school-based asthma management program. J Sch Health 2006; 76:291-296.