- 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:
- In children and adolescents, self-management education can reduce symptoms, school absenteeism, and visits to emergency treatment services [Guevara et al, 2003; Bhogal et al, 2006]. There is less evidence of benefit of written action plans for very young children [Haby et al, 2001; Wolf et al, 2002; DTB, 2005].
- In teenagers, innovative approaches, such as web-based or peer-based delivery (at school), appear to be more successful than traditional programmes [SIGN and BTS, 2011].
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