Two for one: a self-management plan coupled with a prescription sheet for children with asthma

Abstract

Background: Despite strong recommendations in the asthma guidelines, the use of written self-management plans remains low among asthmatic patients.

Objectives: To develop a written self-management plan, based on scientific evidence and expert opinions, in a format intended to facilitate its dispensing by health care professionals, and to test the perception of its relevance and clarity by asthmatic children, adolescents and adults.

Methods: Inspired by previously tested self-management plans, surveys of asthma educators, expert opinions and the 2004 Canadian Asthma Guidelines, the authors simultaneously developed French and English versions of a written self-management plan that coupled with a prescription. The self-management plan was tested in parents and their asthmatic children (aged one to 17 years), and it was revised until 85% clarity and perceived relevance was achieved.

Results: Ninety-seven children and their parents were interviewed. Twenty per cent had a self-management plan. On the final revision, nearly all items were clear and perceived relevant by 85% or more of the interviewees. Two self-management plans were designed for clinics and acute care settings, respectively. The plans are divided into three control zones identified by symptoms with optional peak flow values and symbolized by traffic light colours. They are designed in triplicate format with a prescription slip, a medical chart copy and a patient copy.

Conclusion: The written self-management plans, based on available scientific evidence and expert opinions, are clear and perceived to be relevant by children, adolescents and their parents. By incorporating the prescription and chart copies, they were designed to facilitate dispensing by physicians in both clinics and acute care settings.

Figure 1)

The selection of participants

Figure 2)

English (A) and French (B) versions of the self-management plan for clinics. The left panel represents the recto (the pharmacy copy), and is reproduced in triplicate format with the second copy for the medical chart and the third copy for the patient. The right panel represents the verso of the written action plan, and comprises general messages about asthma, the purpose of the action plan and the five steps to maintain asthma control. The self-management plan for the acute care setting will be available on request