Formative Evaluation for Implementation of a Low Literacy Pictorial Asthma Action Plan Delivered via Telehealth Improves Asthma Control

2020 ◽  
pp. 106286062094683
Author(s):  
Monique K. Vallabhan ◽  
Elizabeth Y. Jimenez ◽  
Grace L. McCauley ◽  
Holly Willyard ◽  
Alberta S. Kong
Keyword(s):  
Asthma Control ◽  
Formative Evaluation ◽  
Action Plan ◽  
The United States ◽  
Direct Care ◽  
Face Validity ◽  
Direct Patient Care ◽  
Low Literacy ◽  
Asthma Control Test ◽  
Asthma Action Plan

Consistently uncontrolled asthma in children is an increasing concern in the United States. The use of asthma action plans with asthma education is inconsistent and may be improved with adaptations for low literacy. The objective of this study was formative evaluation for implementation of the New Mexico Pictorial Asthma Action Plan (NM PicAAP). Quality improvement processes guided NM PicAAP face validation and telehealth direct patient care implementation. The asthma control test was selected to measure asthma control. NM PicAAP was revised for face validity, and training curriculum on its use and telehealth implementation processes were developed. Seven youth received NM PicAAP via telehealth direct care, which increased overall asthma control scores over 1 month. NM PicAAP may be useful and effective for improving asthma care in children via telehealth. Additional testing is needed to assess applicability.

scholarly journals Comparing Written Versus Pictorial Asthma Action Plans to Improve Asthma Management and Health Outcomes Among Children and Adolescents: Protocol of a Pilot and Feasibility Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Lisa Hynes ◽  
Kristine Durkin ◽  
Desireé N Williford ◽  
Hope Smith ◽  
David Skoner ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Children And Adolescents ◽  
Asthma Control ◽  
Treatment Guidelines ◽  
Action Plan ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Reading Level ◽  
Randomized Controlled ◽  
Asthma Action Plan

BACKGROUND Asthma is an important focus for pediatric health research as management of asthma symptoms is a significant challenge, and morbidity and mortality among youths with asthma remain prevalent. Treatment guidelines for asthma recommend a written asthma action plan (WAAP) that summarizes individualized instructions for daily medication use. However, WAAPs are typically written at a seventh- to ninth-grade reading level, which can be a barrier to young people in understanding their treatment, having confidence in using a WAAP, and engaging with asthma education. OBJECTIVE Utilizing a feasibility and pilot randomized controlled trial (RCT) design, the objective of the Take Action for Asthma Control study is to test a symptom-based, computer-generated pictorial asthma action plan (PAAP) in comparison with a standard WAAP and assess the feasibility and acceptability of the asthma action plan (AAP) intervention and study procedures. The study has 3 aims: (1) estimate the effect sizes of PAAPs compared with WAAPs on outcomes (eg, AAP knowledge and medication adherence), (2) evaluate feasibility and acceptability of AAP intervention and RCT procedures from the perspectives of key stakeholders, and (3) establish whether parent and youth literacy levels are associated with treatment outcomes. METHODS This feasibility and pilot RCT is a block randomized, 2-arm, parallel-group clinical trial, lasting 6 months in duration. At baseline, participants will be randomly assigned to receive a PAAP or WAAP generated for them and reviewed with them by their asthma physician. Study procedures will take place over 4 separate time points: a baseline clinic appointment, 1-month telephone follow-up, and 3- and 6-month clinic-based follow-ups. At each time point, data will be collected related to the main outcomes: AAP knowledge, AAP satisfaction, asthma control, pulmonary function, and adherence to daily asthma medication. A sample size of up to 60 participants (aged 8-17 years) will be recruited. Feasibility and acceptability data will be collected via one-to-one qualitative interviews with providers involved in the study and a subgroup of families that participate in the study. RESULTS Recruitment and data collection began in May 2017 and were completed in October 2018. CONCLUSIONS This pilot and feasibility study will test the potential efficacy, feasibility, and acceptability of an AAP intervention and study procedures. The findings will inform the design and delivery of a future definitive trial to assess the efficacy of PAAPs versus WAAPs in supporting asthma self-management among children and adolescents. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11733

scholarly journals The Role of Pharmacists in General Practice in Asthma Management: A Pilot Study

Pharmacy ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 114 ◽  
Author(s):  
Louise Deeks ◽  
Sam Kosari ◽  
Katja Boom ◽  
Gregory Peterson ◽  
Aaron Maina ◽  
...  
Keyword(s):  
General Practice ◽  
Pilot Study ◽  
Asthma Control ◽  
Action Plan ◽  
Asthma Management ◽  
Asthma Control Test ◽  
Appropriate Prescribing ◽  
Device Use ◽  
Practice Methods

Background: Asthma is principally managed in general practice. Appropriate prescribing and medication use are essential, so general practice pharmacists appear suitable to conduct asthma management consultations. This pilot study aimed to evaluate the asthma management role of a pharmacist in general practice. Methods: Analysis of an activity diary and stakeholder interviews were conducted to identify interventions in asthma management; determine whether asthma control changed following pharmacist input; and determine acceptability of asthma management review by a pharmacist in one general practice in Canberra, Australia. Results: Over 13 months, the pharmacist saw 136 individual patients. The most common activities were asthma control assessment; recommendations to adjust medication or device; counselling on correct device use; asthma action plan development and trigger avoidance. For patients with multiple consultations, the mean Asthma Control Test score improved from the initial to last visit (14.4 ± 5.2 vs. 19.3 ± 4.7, n = 23, p < 0.0001). Eight of the 19 (42%) patients moved from having poor to well-controlled asthma. Case studies and qualitative data indicated probable hospital admission avoidance and stakeholder acceptability of asthma management by a practice pharmacist. Conclusions: This pilot study demonstrated it is feasible, acceptable and potentially beneficial to have a general practice pharmacist involved in asthma management. Fuller evaluation is warranted.

scholarly journals Smartphone app for asthma self-management – a literature review of contents and functions

2019 ◽  
Vol 10 (4) ◽  
pp. 3269-3276
Author(s):  
Ghozali MT ◽  
Satibi ◽  
Zullies Ikawati ◽  
Lutfan Lazuardi
Keyword(s):  
Asthma Control ◽  
Action Plan ◽  
Asthma Management ◽  
Self Management ◽  
Smartphone App ◽  
Asthma Control Test ◽  
Quality Health ◽  
The Many ◽  
Air Quality Health Index

A self-management is an important thing in achieving optimum health outcomes. One of the many effective ways that help improve the outcomes of self-management in asthma is through the use of smartphone applications or popularly known as apps. The apps have been designed to help patients in controlling asthma complaints. This study aimed to examine contents and functions featured in the reviewed studies as well as to suggest what functions and contents should be featured in an asthma self-management smartphone app. This study used a systematic approach to examine and review the contents and functions of asthma management apps from selected studies. Inclusion criteria of the study included studies related to the use of asthma control or asthma self-management apps, providing information about contents and features of asthma apps, apps in the reviewed studies designed for laypersons or patients, studies published in peer-reviewed scientific journals in English, and original articles. All the studies had been taken from 2013 to 2018 from three databases, namely Pubmed, Science Direct, and ProQuest. Exclusion criteria included full text unable to be accessed and unable to obtain complete full statistical data. Results of this study showed that the most popular functions and contents featured in the asthma apps involved asthma education, medication use monitor, medication reminder, asthma control test, peak flow meter, asthma symptom monitor, and asthma action plan. Less popular functions and contents included a chat with others, Air Quality Health Index, and Quality of Life Questionnaires. 

A pictorial asthma action plan to improve asthma control in Malaysian adults

2021 ◽  
Author(s):  
Sazlina Shariff Ghazali ◽  
Ping Yein Lee ◽  
Ai Theng Cheong ◽  
Hani Syahida Salim ◽  
Norita Hussein ◽  
...  
Keyword(s):  
Asthma Control ◽  
Action Plan ◽  
Asthma Action Plan

Efficacy of Chinese Children's Asthma Action Plan in the management of children with asthma

2020 ◽  
Vol 41 (1) ◽  
pp. e3-e10
Author(s):  
Kang Zhu ◽  
Li Xiang ◽  
Kunling Shen
Keyword(s):  
Pulmonary Function ◽  
Asthma Control ◽  
Action Plan ◽  
Intervention Group ◽  
Control Group ◽  
Asthma Care ◽  
Number Of Patients ◽  
Children With Asthma ◽  
Asthma Action Plan

Background: Abundant evidence has proven the effectiveness of following an asthma action plan for children. China released its first children's asthma action plan in 2017 to improve asthma control. Objective: To assess the effectiveness of the Chinese Children's Asthma Action Plan (CCAAP) in the management of children with asthma. Methods: Children with persistent asthma (6‐14 years old) at 10 tertiary hospitals were randomized to receive either CCAAP instructions (intervention group, n = 87) or no plan (control group, n = 86) in addition to the usual asthma care, including education, stepwise asthma therapy, and regular outpatient follow-up. Children were followed up by using a serial measurement of outcomes over the course of 3 months. Results: CCAAP instructions did not have a significant effect on any of outcomes compared with the intervention group: (1) variables related to asthma exacerbation, including the number of patients (p = 0.09), symptomatic days (p = 0.658), severity, medication (courses of reliever, p = 0.696; combined rhinitis medication, p = 0.081; combined oral antibiotics, p = 0.852), missed work days (p = 0.538) or school days (p = 0.441), and economic costs (p = 0.898); (2) asthma control (p = 0.180); or (3) pulmonary function parameters during the follow-up period. Both groups showed significant improvement in asthma control (both p < 0.001) and pulmonary function (p < 0.017) from baseline to the 3-month follow-up. Conclusion: The results of this study indicated that provision of CCAAP may play a useful role in the management of children with asthma, but there were no greater benefits than usual asthma care. We need to plan a larger appropriately powered study.

The effectiveness of a pictorial asthma action plan for improving asthma control and the quality of life in illiterate women

2013 ◽  
Vol 51 (4) ◽  
pp. 423-428 ◽  
Author(s):  
Leyla Pur Ozyigit ◽  
Bahar Ozcelik ◽  
Seda Ozcan Ciloglu ◽  
Feyza Erkan
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Action Plan ◽  
Asthma Action Plan

A Low-Literacy Asthma Action Plan to Improve Provider Asthma Counseling: A Randomized Study

PEDIATRICS ◽  
2015 ◽  
Vol 137 (1) ◽  
pp. e20150468 ◽  
Author(s):  
H. Shonna Yin ◽  
Ruchi S. Gupta ◽  
Suzy Tomopoulos ◽  
Alan L. Mendelsohn ◽  
Maureen Egan ◽  
...  
Keyword(s):  
Action Plan ◽  
Randomized Study ◽  
Low Literacy ◽  
Asthma Action Plan

scholarly journals Development and equivalence of new faces for inclusion in the Childhood Asthma Control Test (C-ACT) response scale

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Kate Sully ◽  
Nicola Bonner ◽  
Helena Bradley ◽  
Robyn von Maltzahn ◽  
Rob Arbuckle ◽  
...  
Keyword(s):  
Asthma Control ◽  
Childhood Asthma ◽  
The United States ◽  
Reverse Order ◽  
Control Test ◽  
Response Scale ◽  
Asthma Control Test ◽  
Alternative Response ◽  
Response Option ◽  
Stage 1

Abstract Background Accurate symptom monitoring is vital when managing pediatric asthma, providing an opportunity to improve control and relieve associated burden. The CHILDHOOD ASTHMA CONTROL TEST (C-ACT) has been validated for asthma control assessment in children; however, there are concerns that response option images used in the C-ACT are not culturally universal and could be misinterpreted. This cross-sectional, qualitative study developed and evaluated alternative response option images using interviews with children with asthma aged 4–11 years (and their parents/caregivers) in the United States, Spain, Poland, and Argentina. Interviews were conducted in two stages (with expert input) to evaluate the appropriateness, understanding and qualitative equivalence of the alternative images (both on paper and electronically). This included comparing the new images with the original C-ACT response scale, to provide context for equivalence results. Results Alternative response option images included scale A (simple faces), scale B (circles of decreasing size), and scale C (squares of decreasing quantity). In Stage 1, most children logically ranked images using scales A, B and C (66.7%, 79.0% and 70.6%, respectively). However, some children ranked the images in scales B (26.7%) and C (58.3%) in reverse order. Slightly more children could interpret the images within the context of their asthma in scale B (68.4%) than A (55.6%) and C (47.5%). Based on Stage 1 results, experts recommended scales A (with slight modifications) and B be investigated further. In Stage 2, similar proportions of children logically ranked the images used in modified scales A (69.7%) and B (75.7%). However, a majority of children ranked the images in scale B in the reverse order (60.0%). Slightly more children were able to interpret the images in the context of their asthma using scale B (57.6%) than modified scale A (48.5%). Children and parents/caregivers preferred modified scale A over scale B (78.8% and 90.9%, respectively). Compared with the original C-ACT, most children selected the same response option on items using both scales, supporting equivalency. Following review of Stage 2 results, all five experts agreed modified scale A was the optimal response scale. Conclusions This study developed alternative response option images for use in the C-ACT and provides qualitative evidence of the equivalency of these response options to the originals.

scholarly journals Supported self-management for asthma

Breathe ◽  
2015 ◽  
Vol 11 (2) ◽  
pp. 98-109 ◽  
Author(s):  
Hilary Pinnock
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Management Education ◽  
Action Plan ◽  
Skills Training ◽  
Evidence Base ◽  
Self Management ◽  
List Type ◽  
Asthma Action Plan

Key pointsSelf-management education in asthma is not an optional extra. Healthcare professionals have a responsibility to ensure that everyone with asthma has personalised advice to enable them to optimise how they self-manage their condition.Overviews of the extensive evidence-base conclude that asthma self-management supported by regular professional review, improves asthma control, reduces exacerbations and admissions, and improves quality of life.Self-management education should be reinforced by a written personalised asthma action plan which provides a summary of the regular management strategy, how to recognise deterioration and the action to take.Successful implementation combines education for patients, skills training for professionals in the context of an organisation committed to both the concept and the practice of supported self-management.Educational aimsTo summarise the evidence base underpinning supported self-management for asthmaTo provide clinicians with a practical approach to providing supported self-management for asthmaTo suggest an appropriate strategy for implementing supported self-managementSummaryThe evidence in favour of supported self-management for asthma is overwhelming. Self-management including provision of a written asthma action plan and supported by regular medical review, almost halves the risk of hospitalisation, significantly reduces emergency department attendances and unscheduled consultations, and improves markers of asthma control and quality of life. Demographic and cultural tailoring enables effective programmes to be implemented in deprived and/or ethnic communities or within schools.A crucial component of effective asthma self-management interventions is the provision of an agreed, written personalised action plan which advises on using regular medication, recognising deterioration and appropriate action to take. Monitoring can be based on symptoms or on peak flows and should specify thresholds for action including increasing inhaled steroids, commencing oral steroids, and when (and how) to seek professional help. Plans should be personalised to reflect asthma severity and treatment regimes, avoidance of triggers, co-morbid rhinitis and the individual’s preferences.Implementation is a challenge. Systematic review evidence suggests that it is possible to implement asthma self-management in routine care, but that to be effective this requires a whole systems approach which considers implementation from the perspective of patient education and resources, professional skills and motivation and organisation priorities and routines.

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