Feasibility of supported self-management with a pictorial action plan to improve asthma control

Sazlina, Shariff Ghazali and Lee, Ping Yein and Cheong, Ai Theng and Hussein, Norita and Pinnock, Hilary and Salim, Hani and Liew, Su May and Hanafi, Nik Sherina and Abu Bakar, Ahmad Ihsan and Ng, Chiu-Wan and Ramli, Rizawati and Ahad, Azainorsuzila Mohd and Ho, Bee Kiau and Isa, Salbiah Mohamed and Parker, Richard A. and Stoddart, Andrew and Pang, Yong Kek and Chinna, Karuthan and Sheikh, Aziz and Khoo, Ee Ming and Collaboration, RESPIRE (2022) Feasibility of supported self-management with a pictorial action plan to improve asthma control. NPJ Primary Care Respiratory Medicine, 32 (1). ISSN 2055-1010, DOI https://doi.org/10.1038/s41533-022-00294-8.

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Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feasibility study, and observing the change in clinical and cost outcomes of pictorial action plan use is part of assessing feasibility as it will help us decide on outcome measures for a fully powered RCT. We conducted a pre-post feasibility study among adults with physician-diagnosed asthma on inhaled corticosteroids at a public primary-care clinic in Malaysia. We adapted an existing pictorial asthma action plan. The primary outcome was asthma control, assessed at 1, 3 and 6 months. Secondary outcomes included reliever use, controller medication adherence, asthma exacerbations, emergency visits, hospitalisations, days lost from work/daily activities and action plan use. We estimated potential cost savings on asthma-related care following plan use. About 84% (n = 59/70) completed the 6-months followup. The proportion achieving good asthma control increased from 18 (30.4%) at baseline to 38 (64.4%) at 6-month follow-up. The proportion of at least one acute exacerbation (3 months: % difference -19.7; 95% CI -34.7 to -3.1; 6 months: % difference -20.3; 95% CI -5.8 to -3.2), one or more emergency visit (1 month: % difference -28.6; 95% CI -41.2 to -15.5; 3 months: % difference -18.0; 95% CI -32.2 to -3.0; 6 months: % difference -20.3; 95% CI -34.9 to -4.6), and one or more asthma admission (1 month: % difference -14.3; 95% 0 -25.2 to -5.3; 6 months: % difference -11.9; 95% CI -23.2 to -1.8) improved over time. Estimated savings for the 59 patients at 6-months follow-up and for each patient over the 6 months were RM 15,866.22 (USD3755.36) and RM268.92 (USD63.65), respectively. Supported self-management with a pictorial asthma action plan was associated with an improvement in asthma control and potential cost savings in Malaysian primary-care patients.

Item Type: Article
Funders: UK National Institute for Health Research (NIHR) (Global Health Research Unit on Respiratory Health (RESPIRE)
Uncontrolled Keywords: Health-care; Communication; Asthma control
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Medicine > Medicine Department
Faculty of Medicine > Primary Care Medicine Department
Faculty of Medicine > Social & Preventive Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 24 Nov 2023 01:57
Last Modified: 24 Nov 2023 01:57
URI: http://eprints.um.edu.my/id/eprint/41297

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