Written Asthma Actions Plans Versus No Written Instructions In Specialty Care
Condition: Asthma
MeSH terms: Asthma
Study type: Interventional

Summary: 
      The overall goal of this randomized, controlled study is to compare a model written treatment
      plan with the usual care that is provided by a group of adult and pediatric pulmonologists
      and allergists in their practice settings. The written treatment plan is a form that allows a
      treatment regimen that is consistent with National Heart, Lung, and Blood Institute (NHLBI)
      guidelines to be conveyed to patients. Barriers to the use of written plans will be
      identified to better understand why some patients and physicians use written treatment plans
      more frequently and effectively than others. An additional goal is to assess how patients
      from different racial/ethnic backgrounds utilize treatments plans. Because asthma
      disproportionately affects African American and Latino patients, another goal of this study
      is to better understand if there are fundamental differences in the way patients from
      racial/ethnic minority groups self-manage asthma in comparison to their white counterparts.
      The study will also try to determine if differences exist in the way physicians care for
      minority patients. If there are differences, it is important to determine if the disparities
      can be overcome with the use of a written treatment plan form.
    

Detailed description: 
      BACKGROUND:

      Effective self-management of asthma requires that patients, or their caregivers, recognize
      the early symptoms of an exacerbation and initiate appropriate interventions aimed at
      preventing the progression of symptoms. Most asthma clinical guidelines suggest that the
      incorporation of a written self-management plan is essential. Patients must possess,
      understand, and follow a written plan if they are to respond appropriately to changes in
      asthma status. Nevertheless, there are no controlled studies examining the efficacy of the
      written plan itself. Furthermore, even if written plans are an essential and effective
      component of successful self-management, the data suggest that few patients receive these
      plans. If patients and physicians are to increase their use of written plans, the barriers to
      the use of these plans need further investigation.

      DESIGN NARRATIVE:

      The three primary outcome measures of this study are as follows: 1) reduction in asthma
      symptom frequency; 2) reduction in urgent, unscheduled, and emergency visits for asthma; and
      3) improved quality of life. These outcomes will be measured over a 12-month period.

      The following four secondary outcome measures will also be examined: 1) hospitalizations due
      to asthma; 2) days with activity restriction; 3) the proportion of patients in the
      intervention group who are given the model written plan form during the initial visit; and 4)
      the proportion of patients in the intervention group who have the model treatment plan at the
      end of the follow-up period. These outcomes will be measured over a 12-month period.
    

Intervention name(s): Written Asthma Action Plan
Intervention type(s): Behavioral
Other intervention name(s): Asthma Treatment Plans; Action Plans
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Asthma Action Plans; African Americans; Latinos; Health Literacy; Asthma Education