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Am J Respir Crit Care Med. 2015 Jun 15;191(12):1374-83. doi: 10.1164/rccm.201407-1338OC.

Do Patients of Subspecialist Physicians Benefit from Written Asthma Action Plans?

Author information

1
1 Department of Pediatrics and.
2
2 Department of Medicine, College of Physicians and Surgeons, and.
3
3 Albert Einstein College of Medicine, Bronx, New York.
4
4 Department of Biostatistics and.
5
5 Weill Cornell Medical College, New York, New York; and.
6
6 Department of Medicine and.
7
7 Department of Pediatrics, Harlem Hospital Center, New York, New York.
8
8 Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York.

Abstract

RATIONALE:

Asthma clinical guidelines suggest written asthma action plans are essential for improving self-management and outcomes.

OBJECTIVES:

To assess the efficacy of written instructions in the form of a written asthma action plan provided by subspecialist physicians as part of usual asthma care during office visits.

METHODS:

A total of 407 children and adults with persistent asthma receiving first-time care in pulmonary and allergy practices at 4 urban medical centers were randomized to receive either written instructions (n = 204) or no written instructions other than prescriptions (n = 203) from physicians.

MEASUREMENTS AND MAIN RESULTS:

Using written asthma action plan forms as a vehicle for providing self-management instructions did not have a significant effect on any of the primary outcomes: (1) asthma symptom frequency, (2) emergency visits, or (3) asthma quality of life from baseline to 12-month follow-up. Both groups showed similar and significant reductions in asthma symptom frequency (daytime symptoms [P < 0.0001], nocturnal symptoms [P < 0.0001], β-agonist use [P < 0.0001]). There was also a significant reduction in emergency visits for the intervention (P < 0.0001) and control (P < 0.0006) groups. There was significant improvement in asthma quality-of-life scores for adults (P < 0.0001) and pediatric caregivers (P < 0.0001).

CONCLUSIONS:

Our results suggest that using a written asthma action plan form as a vehicle for providing asthma management instructions to patients with persistent asthma who are receiving subspecialty care for the first time confers no added benefit beyond subspecialty-based medical care and education for asthma. Clinical trial registered with www.clinicaltrials.gov (NCT 00149461).

KEYWORDS:

action plans; asthma; minority; physicians; self-management

PMID:
25867075
PMCID:
PMC4476559
DOI:
10.1164/rccm.201407-1338OC
[Indexed for MEDLINE]
Free PMC Article

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