Detailed action plans reduce risks
04 February 2004

People with asthma are being encouraged by experts to use written action plans to help them control their own symptoms, after a new study once again reinforced their effectiveness.

Action plans are agreed by health professionals in discussion with patients. They help patients to monitor their own symptoms, identify when their asthma is deteriorating and to change medication accordingly to keep symptoms under control.

Research has repeatedly confirmed that action plans are one of the most effective ways of controlling asthma and reducing the need for emergency care, yet a National Asthma Campaign study found that only 3% of people with asthma use one.

Action plans have different elements and instructions. In this recent study, published in Thorax, Dr Peter Gibson and Heather Powell at the John Hunter Hospital in Newcastle, Australia, compared the impact of individual components of different types of action plans to find out which were of most benefit.

The research suggested that for plans to be most effective they must include the following:

• personal best peak flow readings
• guidelines for increasing inhaled steroids
• guidelines for beginning a course of oral steroids
  

Research has shown that self-management education is effective. Scientists in 2000 reviewed 36 trials which compared self-management with other care. They found that those people with asthma who had received education about controlling their symptoms were 40% less likely to be hospitalised with their asthma, and 20% less likely to have to go to A&E. Visits to the doctor, night-time symptoms and days off work or school were also reduced.

'All people with asthma should have a written action plan drawn up with their GP and tailored to their individual circumstances,' said Katie Shepherd, the Campaign's care development manager.
'Plans cost nothing, and by putting people in control of their symptoms, they can mean a better quality of life.'

This view was endorsed by Professor Martyn Partridge, the Campaign's chief medical adviser, in his editorial in Thorax highlighting the new research: 'There can be no further excuse for delaying widespread implementation of the issuing of written personal asthma plans.'