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Sample Topic: Asthma

Asthma : Last revised in December 2013

Evidence on self-management education and action plans

  • People experience one-third to two-thirds reduction in hospitalizations, emergency department visits, missed days of work, and nocturnal wakening. Implementation of one self-management programme in 20 people prevents one hospitalization. Less intensive interventions (not involving a written action plan) appear to be less effective [GINA, 2006].
  • Written action plans improve health outcomes for people with asthma, as part of self-management education. The evidence is particularly good for people who have had a recent exacerbation [Gallefoss and Bakke, 2000; Moudgil et al, 2000; Cote et al, 2001; Guevara et al, 2003; Gibson and Powell, 2004; Rodolfo et al, 2005; Rees, 2006; SIGN and BTS, 2011]:
    • A systematic review (search date November 2004, four randomized controlled trials, n = 355) suggested that children prefer symptom-based monitoring action plans over peak flow-based monitoring action plans (RR 1.21, 95% CI 1.00 to 1.46), but parents showed no preference. Exacerbation rates, admissions, school absenteeism, lung function, symptom score, quality of life, and withdrawals did not differ significantly between types of action plans [Bhogal et al, 2006].
  • Self-management education: