Understanding what asthma plans mean: a linguistic analysis of terminology used in published texts (original) (raw)
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Asthma control and action plans
The European respiratory journal, 2017
KOURI et al. [1] in Canada have developed a tool to guide completion of asthma action plans (AAPs). In their rationale, they suggest that "fewer than 25% of patients receive an AAP, partly due to prescribers' inability to complete 'yellow zone' instructions (how to intensify therapy for acute loss of control)". The authors "reviewed recent asthma guidelines and adult studies addressing acute loss of asthma control" and "developed evidence-based rules for yellow zone therapy and operational guidelines to maximise adherence and minimise errors". There is a substantial inherent flaw in this study, both in its rationale and methodology. The authors suggested that completing yellow-zone instructions equates with advice regarding how to intensify therapy for acute loss of control.
A qualitative study of action plans for asthma
BMJ, 2002
Objectives To investigate the perspectives of patients with asthma on the use of an action plan and the implementation of this plan during an asthma attack that culminated in a visit to an emergency department. Design Qualitative study. Setting Tertiary teaching hospital, suburban hospital, and rural hospital. Participants 62 patients aged 18 to 69 years who presented to an emergency department with asthma over a two month period.
Use of written treatment plans for asthma by specialist physicians
Pediatric Pulmonology, 2007
Few studies have addressed use of written treatment plans (WTPs) for asthma by specialist physicians. The purpose of this study is to characterize the attitudes, beliefs, and selfreported practice behaviors regarding asthma WTP use among specialist physicians. Structured interviews were conducted with pulmonologists and allergists who provide direct patient asthma care in two New York City medical centers. The interview covered five areas: (1) demographic information;
Journal of Tropical Pediatrics, 2014
Background: The provision of written asthma action plans (WAAPs) is regarded by regional and international guidelines as an essential component of patient education and self-management. However, the evidence for this practice in children is deficient. Aim: To evaluate the effectiveness of adding a personalized WAAP in the treatment of children with partly controlled asthma. Methods: Children with partly controlled asthma were randomized to receive a personalized WAAP or no plan, in addition to standard care including education. They were followed up with serial measurement of outcome variables. The primary outcome measured was the number of emergency room (ER) revisits. Results: Ninety-one children participated, 45 in the intervention group and 46 in the control group. Comparison with pretrial data revealed significantly improved outcomes with respect to the numbers of ER visits (p ¼ 0.005 and 0.0002) and acute asthmatic attacks (p ¼ 0.0064 and 0.0006) in both arms of the study. Children in receipt of a personalized WAAP had fewer ER visits (p ¼ 0.78), asthma attacks (p ¼ 0.84), missed school days (p ¼ 0.28), night-time awakenings (p ¼ 0.48) and unscheduled doctor visits (p ¼ 0.69) than those who did not receive a plan. Conclusion: The results of this study suggest that the provision of personalized WAAPs may play a useful role in the management of children with partly controlled asthma but is no better than standard care. Asthma education is a critical component in the prevention of exacerbations in children with partly controlled asthma. Key words: action plan, asthma, childhood asthma, personalized written plan. duct of this study. The cooperation of Head Nurse Dass, Staff Nurses and medical records clerks were invaluable in assisting with data collection. The authors are also greatly appreciative of the inputs of the following On the Job Trainees (OJTs) and now medical students:
Factors associated with ownership and use of written asthma action plans in North-West Melbourne
Primary care respiratory journal : journal of the General Practice Airways Group, 2004
Written asthma action plans (WAAPs) have become a core component of asthma management in Australia. We investigated ownership, utilisation and factors associated with ownership of asthma action plans by caregivers. 443/776 (57%) caregivers of children aged 2-14 years with asthma were identified from 32 GP clinics as part of a randomised controlled trial (RCT), and completed self-administered questionnaires. Only 29% of participants owned a WAAP, while 13% possessed verbal instructions, and 56% had no plan. An asthma action plan for children, which was developed by a general practitioner (GP) was more likely to comprise verbal instructions (p = 0.001), while action plans developed by paediatricians were more likely to be written (p < 0.001). Just over one half of caregivers (59%) reported discussing their child's action plan the last time they visited their doctor for asthma. Factors associated with WAAP ownership included nights waking (p = 0.013), self reported severity (p =...
An evidence-based, point-of-care tool to guide completion of asthma action plans in practice
The European respiratory journal, 2017
Asthma action plans (AAPs) reduce healthcare utilisation, improve quality of life and are recommended across guidelines. However, fewer than 25% of patients receive an AAP, partly due to prescribers' inability to complete "yellow zone" instructions (how to intensify therapy for acute loss of control). We sought to review best evidence to develop a practical, evidence-based tool to facilitate yellow zone guidance in adults.We reviewed recent asthma guidelines and adult studies addressing acute loss of asthma control (January 2010 to March 2016). We developed evidence-based rules for yellow zone therapy and operational guidelines to maximise adherence and minimise errors.We reviewed three guidelines and 11 manuscripts (2486 abstracts screened). Recommendations were comparable but some areas lacked guidance. For 15/43 asthma regimens, the commonly recommended four- to five-fold yellow zone inhaled corticosteroid dose increase was problematic due to regulatory dose limits....