Factors associated with ownership and use of written asthma action plans in North-West Melbourne
Date
2004
Authors
Sulaiman, N.
Barton, C.
Abramson, M.
Liaw, S.
Harris, C.
Chondrosa, P.
Dharmage, S.
Clarke, D.
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Journal article
Citation
Primary Care Respiratory Journal, 2004; 13(4):211-217
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N.D. Sulaiman, C.A. Barton, M.J. Abramson, T. Liaw, C. Harris, P. Chondros, S. Dharmage and D. Clarke
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Abstract
Purpose: Written asthma action plans (WAAPs) have become a core component of asthma management in Australia. We investigated ownership, utilisation and factors associated with ownership of asthma action plans by caregivers. Methods: 443/776 (57%) caregivers of children aged 2–14 years with asthma were identified from 32 GP clinics as part of a randomised controlled trial (RCT), and completed self-administered questionnaires. Results: Only 29% of participants owned a WAAP, while 13% possessed verbal instructions, and 56% had no plan. An asthma action plan for children, which was developed by a general practitioner (GP) was more likely to comprise verbal instructions (p = 0.001), while action plans developed by paediatricians were more likely to be written (p < 0.001). Just over one half of caregivers (59%) reported discussing their child’s action plan the last time they visited their doctor for asthma. Factors associated with WAAP ownership included nights waking (p = 0.013), self reported severity (p = 0.001), and days lost from school (p = 0.037). Children who had seen a GP in the last 3 months for asthma, or who had been to the Emergency Department (ED) or hospital were more likely to possess a WAAP (p < 0.001). Caregivers who were less satisfied with their child’s asthma control were more likely to own a WAAP (p = 0.037). Caregivers with any action plan found it useful and 82% reported using their action plan for management of an acute attack. However, caregivers with a WAAP were more likely to adhere to the plan for an acute attack compared to caregivers with verbal instructions (OR = 4.5, p < 0.05). Caregivers with a WAAP were more knowledgeable about asthma (p = 0.002), better able to recognise the difference between preventer and reliever medications (p = 0.01), and better able to recognise an asthma attack (p = 0.006). Conclusions: Ownership of WAAPs in this group was still too low. Importantly, caregivers with written instructions were more knowledgeable about asthma and more likely to report following the action plan during an asthma attack.
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Copyright © 2004 General Practice Airways Group Published by Elsevier Ltd.