Written Action Plan in Pediatric Emergency Room Improves Asthma Prescribing, Adherence, and Control

Ducharme, Francine M; Zemek, Roger; Chalut, Dominic; McGillivray, David; Noya, Francisco; Resendes, Sandy; Khomenko, Lyudmyla; Rouleau, Rachel; Zhang, Xun

doi:10.1164/rccm.201001-0115oc

Cited by 149 publications

(134 citation statements)

References 52 publications

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“…A trial conducted with 219 children with asthma treated in the ED demonstrated that the WAAP group was more likely to adhere to inhaled corticosteroids, fill oral corticosteroid prescriptions, and report better asthma control at 28 days postdischarge (26).…”

Section: Discussionmentioning

confidence: 99%

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

DiMango

et al. 2015

Am J Respir Crit Care Med

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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], b-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 subspecialtybased medical care and education for asthma.Clinical trial registered with www.clinicaltrials.gov (NCT 00149461).

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Section: Discussionmentioning

confidence: 99%

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

DiMango

et al. 2015

Am J Respir Crit Care Med

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“…2,[4][5][6] No Brasil, estima-se que haja cerca de 20 milhões de asmáticos, considerando-se uma prevalência de 10%. 7 Nos Estados Unidos, a asma afeta cerca de 5 milhões de crianças.…”

Section: 4unclassified

“…9 Observa-se que, se por um lado, a incidência da asma está aumentando, por outro, não ocorre o mesmo com a adesão às diretrizes nacionais de diagnóstico e tratamento. 2,10 A asma é uma doença crônica frequente na infância, que requer esforços coordenados por crianças, famílias e profissionais de saúde para o controle e tratamento adequados. 3 As orientações clínicas práticas recomendam que os médicos ofereçam educação sobre asma para pacientes e suas famílias.…”

Section: 4unclassified

“…Sua manifestação caracteriza-se clinicamente por episódios recorrentes de dispneia, sibilância, constrição torácica e tosse. 1,2 Além disso, associamse aos episódios de exacerbação da asma a hiperresponsividade das vias aéreas e também uma limitação variável ao fluxo aéreo, que podem ser revertidas por meio de tratamento específico, ou mesmo de modo espontâneo. 3 Compreende-se que a asma é uma doença que se origina pela interação entre herança genética, exposição ambiental a alérgenos e elementos irritantes, além de outros fatores específicos que acarretam o desenvolvimento e a manutenção dos sintomas.…”

Section: Introductionunclassified

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Educação em asma: principais técnicas adotadas em programas de intervenção

Cidade

Roncada

Costa

et al. 2014

Sci Med

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RESUMOObjetivos: Tendo em vista que a educação em asma é importante para aumentar a adesão ao tratamento, e assim, o controle da doença, o objetivo desta revisão foi identificar os principais estudos sobre intervenção de educação em asma. Métodos: Foi realizada uma revisão da literatura para identificar os principais estudos que aplicaram medidas pré e pós-intervenção de educação em asma. Aplicou-se a lógica de pesquisa nas bases de dados PubMed, Lilacs, Scopus, ScienceDirect e Cochrane. Os artigos foram incluídos mediante descrição completa da aplicabilidade das medidas, suas respostas e as conclusões para o desfecho em programas de educação em asma para crianças e adolescentes. Resultados: Doze pesquisas foram incluídas na revisão. Das intervenções encontradas, quatro foram consideradas as mais aconselháveis por apresentarem resultados satisfatórios em relação à melhor compreensão dos diversos aspectos da asma. Conclusões: A educação em asma é fundamental tanto para a adesão do cuidado domiciliar quanto para o autocontrole eficaz da doença. Por essa razão recomenda-se fortemente que, para que sejam alcançados os objetivos de autocontrole da doença e melhor qualidade de vida possível, o processo educativo deva ser individualizado, contínuo, progressivo, dinâmico e sequencial. O programa de controle da asma precisa ser não apenas pontualmente efetivo, mas também regular, para ter maior impacto nos indicadores de saúde e qualidade de vida. ABSTRACTAims: Asthma education is one of the outcomes that should be applied to self-management, in order to increase adherence to treatment, thus increasing the control of the disease. The objective of this review was to identify the main interventional studies for asthma education. Methods: A review was performed to identify the major studies that have applied measures pre and post intervention for asthma education. We applied the logic of searching the databases: PubMed, Lilacs, Scopus, ScienceDirect, and Cochrane. Articles were included after complete description of the applicability of the measures, their answers and conclusions for the outcome in asthma education programs for children and adolescents. Results: Twelve studies were included in the review. Among the interventions found, four were considered the most advisable for presenting satisfactory results in an enhanced understanding of the various aspects of asthma. Conclusions: Asthma education is essential both for the compliance with home care as for effective self-control of the disease. Therefore, it is strongly recommended that in order to achieve the goals of the best possible quality of life and self-control of the disease, the educational process should be individualized, continuous, progressive, dynamic and sequential. The program of asthma control needs to be not only timely, but also regular, to have a greater impact on health indicators and quality of life.

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“…If it was inadequate, review the action plan and provide written guidance to assist if asthma worsens again. 402,403 • Review the patient's use of controller treatment before and during the exacerbation. Was it increased promptly and by how much?…”

mentioning

confidence: 99%

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

Kumbhare

Strange

2018

Southern Medical Journal

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Written Action Plan in Pediatric Emergency Room Improves Asthma Prescribing, Adherence, and Control

Cited by 149 publications

References 52 publications

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

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

Educação em asma: principais técnicas adotadas em programas de intervenção

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

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