Asthma action plans

Asthma action plans help the patient or carer to recognise and respond appropriately to worsening asthma. They are individually tailored according to the pattern of the adult or child's asthma, written and provided for the patient to keep as a wallet-sized card or paper sheet. The plan must be carefully explained to the patient. Patients who do not read need the information explained in a way they can remember.

An individual's plan includes:

1.  Guidance for identifying signs of worsening control, which can include the following:

• increasing frequency or severity of symptoms, especially waking at night with asthma
• the need for increasingly frequent doses of bronchodilator
• failure of bronchodilator to completely relieve symptoms
• falling PEF
• increasing PEF variability.

2. Clear instructions for how to respond to any given change in asthma control, which may include:

• altering medications or doses
• consulting the GP
• attending an emergency care facility.

Written asthma action plans are equally effective when based on PEF monitoring or symptom diaries.

• When PEF is used, the action plan should be based on personal best rather than on predicted values.⁷³
• Inclusion of PEF monitoring in the asthma action plan can be beneficial for people with more severe or difficult-to-control asthma,^{27, 74} and those with poor perception of airflow limitation. See Asthma in the elderly.

When developing the asthma action plan, the patient's individual preferences for decision-making processes should be consulted. Many patients with moderate-to-severe asthma prefer their doctor to make decisions about medication changes.⁷⁵

Templates for asthma action plans are available from the National Asthma Council Australia and Asthma Foundations, and are included in general practice management software.

Asthma action plans for adults

For information on drug therapy, see Principles of drug treatment in adults.

In adults, the use of individualised asthma action plans (also called self-management plans):^63,66

• reduces absences from work
• reduces hospital admissions
• reduces emergency presentations to general practice
• reduces SABA use
• improves lung function.

Asthma action plans for children and adolescents

For information on drug therapy in children, see Principles of drug treatment in children and adolescents

• When choosing the delivery device, take into account the patient's age, the drugs prescribed and (for older children and adolescents) the child's own preferences.
• Encourage parents to give the school a copy of the student's asthma action plan (essential for school trips).
• Some schools request the GP to complete an asthma first aid plan.
• Guidelines for the care of children with asthma while at school (the Asthma-Friendly Schools program) have been developed for Australian schools. For more information contact Asthma Foundations: free call 1800 645 130.

Content Created (Thursday, 16 November 2006)