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Written Asthma Action Plan in Emergency Department Improves Knowledge and Asthma Control among Adult Acute Asthma Patients

Original article

Abstrak

Pengurusan kendiri asma menggunakan pelan tindakan asma secara bertulis (WAAP) penting dalam memastikan pengurusan asma yang berkesan kerana ia mengurangkan kadar kehadiran ke hospital. Kajian ini menilai peningkatan pengetahuan dan kawalan asma menggunakan WAAP di kalangan pesakit asma di Jabatan Kecemasan. Kajian cubaan kawalan rawak ini dijalankan selama 19 bulan di Jabatan Perubatan Kecemasan sebuah hospital universiti. Kajian ini melibatkan pesakit dewasa serangan asma ringan dan sederhana. Pesakit dibahagikan secara rawak kepada dua kumpulan iaitu kumpulan intervensi dan kawalan. Soal selidik pengetahuan penyakit asma diberikan pada pesakit. Pesakit dari kedua kumpulan menerima kaunseling tentang penyakit asma berdasarkan risalah asma yang telah disediakan. Kumpulan intervensi, kemudiannya menerima kaunseling WAAP mengikut keperluan individu tersebut. Kumpulan kawalan menerima kaunseling lisan berdasarkan perawatan. Susulan kajian dijalankan pada 1 dan 3 bulan. Pengetahuan penyakit asma dan kawalan penyakit asma dinilai melalui tinjauan telefon. Lima puluh pesakit telah dibahagikan secara rawak kepada kumpulan intervensi dan kawalan. Setiap kumpulan menerima 25 pesakit. Skor pengetahuan kumpulan intervensi jauh lebih tinggi daripada kawalan (16.88+0.44 vs 13.36+3.72; p<0.001). Kumpulan intervensi mencapai kawalan asma yang baik (skor ACT >19) pada 1 bulan berbanding kumpulan kawalan (20.64+3.26 vs 17.72+4.17). Kedua-dua kumpulan mencapai kawalan yang baik pada 3 bulan. Pengurusan kendiri asma dengan menggunakan WAAP di Jabatan Kecemasan meningkatkan pengetahuan dan kawalan asma di kalangan pesakit yang mendapat serangan asma ringan dan sederhana.

Abstract

Self-management of asthma using the written asthma action plan (WAAP) is important in ensuring effective management of asthma as it reduces hospital visits. This study evaluates the improvement in knowledge and asthma control using WAAP among adult patients with acute asthma presenting to Emergency Department (ED). This randomized control trial was conducted over a 19-month period in an ED of a university hospital. Adult patients with acute mild to moderate asthma were included in the study.  Patients were randomized into intervention and control group. A self-administered knowledge questionnaire was distributed to all patients. Both groups received asthma counselling guided by asthma flyers. The intervention group was further counselled on individualized WAAP. The control group received standard verbal advice upon discharge. Subsequently at 1 month and 3 months a follow up was conducted. Knowledge and asthma control were assessed via a telephone survey. Fifty patients were assigned randomly to intervention (WAAP) and control group. Each group received 25 patients. The knowledge score of the intervention group was significantly more than the control group (16.88+0.44 vs 13.36+3.72; p<0.001). The intervention group achieved good asthma control (ACT score >19) at 1 month compared to control group (20.64+3.26 vs 17.72+4.17). Both groups achieved good control at 3 months follow up. Self-management with WAAP in ED improves knowledge and asthma control among acute mild to moderate asthma patients.