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

Written Asthma Action Plan in Emergency Department
Vol. 15 No. 1 : 2020 (218-224)

Shamsuriani MJ Shamsuriani MJ
Norhidayah MS Norhidayah MS

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.

Keywords : adult, asthma, education, emergency department, prevention,

Correspondance Address
Shamsuriani Md Jamal. Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +6012-295 2725 Email: suriazwa@gmail.com


References
Adams, R.J., Smith, B.J., Ruffin, R.E. 2000. Factors associated with hospital admissions and repeat emergency department visits for adults with asthma. Thorax 55(7): 566-73. Cross, E., Villa -Roel, C., Majumdar, S.R., Mohit, B., Rosychuk, R., Couperthwaite, S., Rowe, B.H. 2014. Action plans in patients presenting to emergency departments with asthma exacerbations: frequency of use and description of contents. Canadian Respiratory Journal 21(6): 351-6. Gibson, P.G., Powell, H. 2004. Written action plans for asthma: an evidence-based review of the key components. Thorax 59(2): 94-9. Gibson, P.G., Powell, H., Wilson, A.J. 2003. Self-management education and regular practitioner review for adults with asthma. Cochrane Database Syst Rev 1: CD001117 Global Initiative For Asthma. 2019. Global Strategy for Asthma Management and Prevention: Updated 2019. https://ginasthma.org/wp-content/uploads/2019/06/GINA-2019-main-report-June-2019-wms.pdf. [20 January 2020]. Global asthma network. 2018. Global Asthma Report 2018. http://www.globalasthmanetwork.org/Global%20Asthma%20Report%202018.pdf. [20 January 2020]. Institute for Public Health (IPH). 2008. The Third National Health and Morbidity Survey 2006 Vol. II. Kuala Lumpur. http://iku.moh.gov.my/nhms [20th January 2020]. Nguyen, V.N., Huynh, T.H., Chavannes, N.H. 2018. Knowledge on self-management and levels of asthma control among adult patients in Ho Chi Minh City, Vietnam. International Journal of General Medicine 11: 81-9. Omar, A., Yin, C.L., Lockman, H., Zainol Abidin, I.Z., Hyder, A.I., Ramadoo, J.M., Md Yasin, M., Mohd. Yusof, M.A., Mohd Zin, M.A., Mohd Isa, N.A., Md Jamal, S., Kin, Y.C. 2017. Clinical Practice Guidelines. Management of Asthma in Adults. Malaysian Health Technology Assessment Section. Putrajaya https://www.moh.gov.my/index.php/pages/view/135?mid=67 [20th January 2020]. Powell, H., Gibson, P.G. 2003. Options for self-management education for adults with asthma. Cochrane Database Syst Rev 1: CD004107 Ring, N., Booth, H., Wilson, C., Hoskins, G., Pinnock, H., Sheikh, A., Jepson, R. 2015. The ‘vicious cycle’ of personalised asthma action plan implementation in primary care: a qualitative study of patients and health professionals’ views. BMC Family Practice 16: 145. Schatz, M., Sorkness, C.A., Li, J.T., Marcus, P., Murray, J.J., Nathan, R.A., Kosinski, M., Pendergraft, T.B., Jhingran, P. 2006. Asthma Control Test: Reliability, validity, and responsiveness in patients not previously followed by asthma specialists. J Allergy Clin Immunol 117(3): 549-56. Tapp, S., Lasserson, T.J., Rowe, B.H. 2007. Education interventions for adults who attend the emergency room for acute asthma. Cochrane Database Syst Rev 3: CD003000.