The Asthma Action Plan: at the fulcrum of individualized asthma care

An individualized intervention to improve asthma management among urban Latino and African-American families

We hypothesized that an educational intervention based on a readiness model would lead to improved health outcomes among patients with asthma. Within a randomized control design in an urban Latino and African-American community we conducted an intensive three-month pediatric intervention. A Family Coordinator provided patient education based on a readiness-to-learn model, and facilitated improved interactions between the patient and the doctor. Family education addressed the most basic learning needs of patients with asthma by improving their perception of asthma symptom persistence using asthma diaries and peak flown measures. The physician intervention focused cliniciancs' attention on patients' diary records and peak flow measures, and encouraged physicians to use stepped action plans. Patients were also tested for allergic sensitization and provided strategies to reduce contact with allergens and other asthma triggers. The results showed significant improvements by intervention group families on measures of knowledge, health belief, self-efficacy, self-regulatory skill, and adherence; decreases in symptom persistence and activity restriction; and increased prescription of anti-inflammatory medication by the physicians of the intervention group families.

Meeting Patient Needs in Asthma Education

Preventable drug-related morbidity and mortality in asthma patients is related to inappropriate behavior by both patients (noncompliance) and health care professionals (prescribing and monitoring). Compliance is the crucial factor for success of a therapeutic regimen. Impacting factors have been identified as skills in administration techniques, interactions between patients and providers, and patient expectations. Beneficial effects on the cost of care and quality of life are gained from increasing level of care available to patients. Intensive education including development of self-monitoring skills, early treatment of exacerbations, and access to regular outpatient and Emergency Room care have been shown to be effective.