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9 Patient education and self management
9.1 self-MAnAGeMent eduCAtion And PersonAlised AsthMA ACtion
PlAns
Written personalised action plans as part of self management education have been shown to
improve health outcomes for people with asthma. 407,678,679,682,690-710 The evidence is particularly
good for those in secondary care with moderate to severe disease, and those who have had recent
exacerbations where successful interventions have reduced hospitalisations and emergency
department attendances in people with severe asthma. 682,705,711,712 A consistent finding in many
studies has been improvement in patient outcomes such as self-efficacy, knowledge and
confidence. 690,701-703,709,713-727
A Patients with asthma should be offered self-management education that focuses on
individual needs, and be reinforced by a written personalised action plan.
A Prior to discharge, in-patients should receive written personalised action plans, given
by clinicians with expertise in asthma management.
9.1.1 COMPONENTS OF A SELF MANAGEMENT PROGRAMME
Self management education is a multi-faceted intervention with wide variation in the construction
of programmes. 728,729 One systematic review has identified key components associated with
beneficial outcome (see Table 15). 730 While self management programmes are effective,
individual components are not effective in isolation reinforcing the need to support the provision
of personalised action plans with patient education. 728,731
Successful programmes vary considerably, but encompass:
9 PAtient eduCAtion And self-MAnAGeMent
Structured education, reinforced with written personal action plans, though the duration,
intensity and format for delivery may vary. 690,729
Specific advice about recognising loss of asthma control, though this may be assessed by
symptoms or peak flows or both. 678,679,690,692,696-698,728,730,732-735
Actions, summarised as two or three action points, to take if asthma deteriorates, including
seeking emergency help, commencing oral steroids (which may include provision of an
emergency course of steroid tablets) recommencing or temporarily increasing inhaled
steroids, as appropriate to clinical severity. 730
Some published studies report long, intensive programmes. 709,736-738 However, there is evidence
that short programmes are as effective, 679,739 and that usual care can be raised to a standard that
incorporates many of the core elements of the successful extensive programmes. 740,741
A introduce personalised action plans as part of a structured educational discussion.
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