PURPOSE OF THE STUDY.
To determine the independent effect of a written action plan (WAP) on asthma outcomes in patients with poorly controlled asthma.
Study patients were aged 3 to 13 years and were part of the Healthy Homes II study, a randomized controlled cohort trial that enrolled 309 low-income children with poorly controlled or persistent asthma from the Seattle area from 2002 to 2004.
Data were collected for primary outcomes, including the control of asthma in the previous 2 weeks and pediatric caregiver quality of life scores. Secondary outcomes measured were unscheduled visits to a clinic, emergency department, or hospital within the last 3 months. Information was gathered about whether they had a WAP available and whether they used the WAP over a year-long period. Patients were classified as users of the WAP if they used it at least once per week.
A total of 251 patients took part in the study; 112 used the WAP. No differences in asthma outcomes were seen between patients who used the WAP and those who did not. No difference was seen in use of urgent health care services or in caregiver quality of life scores.
In this study, the use of a WAP was not independently associated with improved asthma outcomes in this cohort of low-income children who had poorly controlled asthma.
Education of patients and families affected by asthma is essential. Use a WAP in the treatment of patients who have asthma is recommended by national guidelines. This study reminds us that the WAP, although important, is only a part of the treatment plan that is given to patients and the families. One of the many assets WAPs have is that they give some control over the treatment to the patients and their families. The response by the caregivers is an essential part, and the need exists to study this factor in a larger population among different socioeconomic groups.
- Copyright © 2012 by the American Academy of Pediatrics