Asthma action plan for proactive bronchial asthma self-management in adults: a randomized controlled trial

Presentation: Asthma action plan for proactive bronchial asthma self-management in adults: a randomized controlled trial.

Abstract:

Background: Written personalized asthma action plans are recommended as part of patient education and self-management. Objectives: To enable asthmatic adults to proactively self-manage bronchial asthma and sustain asthma quiescent status through the utilization of the Asthma Action Plan (AAP), and to establish a feasible asthmatic/caretaker—health care provider communication. Design: Randomized controlled trial with cluster sampling by pulmonologists.

Setting and participants: The study comprised 320 chronic asthmatic patients attending the chest department at the main health insurance hospital in Alexandria that was randomly allocated as the intervention group (AAIG; n=160) that received standard care and intervention by the AAP and a control group (AACG; n=160) that received the routine standard of care. Data were collected through an interviewing questionnaire. The study continued over a 6-month period and passed into three phase stations. During the preparatory phase, the health care provider managed to explain, fill and simplify the use of the Arabic version of the AAP, to explain the correct utilization of the weekly follow-up form and to emphasize the weekly communication/ visit with the health care provider (HCP) to update their weekly follow-up records. Follow-up was done on the 90th and 180th days from the launch of the study, respectively. The study asthmatics were subjected to history-taking of their asthma symptoms, signs and triggers, and a review of their medical/peak expiratory flow records, as well as his/her daily activity and exercise. Results: The AAIG experienced superiority of the average of the green zone days (‘doing well’) with significantly more episodes of early asthma flare-up self-management concomitant with prominent fewer emergency department visits, hospitalization, admission at the ICU, private health facility, and days of sickness leaves and absenteeism. A preponderance of the high and medium adherence levels to asthma medications, avoidance of asthma triggers and smoking was achieved by the AAIG. Conclusions: AAP was the basis for effective patient–health care provider communication and patient real-time asthma flare-up self-management to achieve and sustain better asthma control in asthmatic adults.

Biography:

Dr. Ekram W. Abd El-Wahab has expertise in early detection, prevention, and control of communicable and non-communicable diseases. Her main research focus is studying the epidemiological trend of endemic diseases and the factors associated with their occurrence, development of simple tools and models for risk assessment and prediction of communicable and non-communicable diseases. She has a passion for improving health and wellbeing. Her open and contextual evaluation model based on responsive constructivists creates new pathways for improving healthcare. She has built this model after years of experience in research, evaluation, teaching, and administration both in health and education institutions. She adopts a methodology for developing disease containment strategies and targeted intervention policies that utilize evaluation, measurement, description, and judgment. It allows for value-pluralism. This approach is responsive to all stakeholders and has a different way of focusing.