Action plans may not be of benefit in all asthma patients
Personal action plans for patients with moderate to severe asthma appear to improve lung function and school attendance, and reduce symptoms and use of health care services, the December issue of the Drug
and Therapeutics Bulletin concludes following a review of published studies. However, it notes that the evidence is less convincing for the use of these plans for patients with milder asthma, particularly in primary care.
The British Thoracic Society/Scottish Intercollegiate Guidelines Network
guidelines suggest that patients with asthma, particularly those admitted
to hospital with an exacerbation, should be offered self-management advice,
including a written personal asthma action plan, says the DTB.
Action plans usually include advice about taking asthma therapy, a definition
of asthma deterioration that requires action, what to do in case of deterioration,
when to return to maintenance therapy and when to seek urgent medical
help. Plans should be negotiated between the patient and health care
professional, says the DTB.
Less consistent results for the clinical benefits of using asthma plans
in primary care may be because it is harder to demonstrate advantages
in patients with milder disease who need to make fewer changes to their
therapy to stay well, it suggests.
Hannah George, respiratory specialist pharmacist at Royal Liverpool University
Hospital NHS Trust, commented: “We use personal asthma action plans
for the majority of our asthmatic patients, regardless of disease severity,
as long as they are agreeable. Action plans won’t be beneficial
if the patient tends not to comply. This is a key area that pharmacists
can get involved in as part of a multidisciplinary approach to asthma
management.”
Action plan templates can be downloaded from www.asthma.org.uk |
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