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Mature matters…
M ature Matters...
F E AT U R I N G T O P I C S F O R A D U LT S W I T H A S T H M A
An Asthma Management Plan Is Important: Put It in Writing By Jan L. Tippett, RN, AE-C
Jan L. Tippett is a registered nurse and certified asthma educator practicing in Sacramento, Calif. Over the past decade, the focus of asthma management has switched dramatically from resolving acute asthma flares once they have occurred to preventing flares in the first place. Preventing asthma from flaring has become the main focus of health care delivery systems for patients with asthma. It is now recognized that the patient’s (or caretaker’s) active participation in the treatment process is essential for early intervention to prevent an episode of asthma from worsening. This also gives them a greater understanding of their illness and its management. Patients and their families are taught to recognize that treatment should be started at home to achieve maximum effectiveness and to avoid the increasing risk of uncontrolled symptoms and decreased quality of life. One means of educating patients and their families about asthma and increasing their role in the treatment process is to create a specific written plan of action for each patient. The
National Heart, Lung, and Blood Institute (NHLBI) guidelines of 1997 and the “2002 Update on Selected Topics” have embraced this approach and refer to this written plan as an asthma action plan (AAP). Think of your AAP as a road map to be followed by you and your health care professionals to help prevent and control asthma flares. The goal of the AAP is to tailor treatment for patients with asthma based on their current asthma condition—whether they are stable or experiencing an asthma flare. The written AAP should be developed through a process in which you and your health care providers collaborate to develop a personalized plan. Because asthma is a dynamic disease, the AAP, by definition, needs to be an ongoing process that is revised as the state of your disease changes. Changes in one’s condition can be brought on by any number of things, including respiratory infection, seasonal triggers, or a change in one’s environment. Who Needs a Written AAP?
The NHLBI recommends that all patients with asthma have a written AAP, regardless of the severity of their disease, which means that patients with mild disease or patients who only have seasonal symptoms should have an AAP. The AAP should help patients assess their actions when they are feeling well and help them
The written AAP should be developed through a process in which you and your health care providers collaborate to develop a personalized plan.
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November/December 2004
recognize early warning signs or symptoms of worsening asthma. The AAP should direct stepped-up treatment with increased asthma symptoms and stepped-down treatment when the patient is feeling better. The AAP should be specific for each patient, based on a patient’s ability to monitor symptoms, access medical care, and understand his or her disease. In some cases, the plan may be as simple as, “If you notice these warning signs, call your healthcare provider,” or it could be detailed to cover medications that a patient may start taking at home. What are the Goals of a Written AAP?
The goals for the patient and the health care provider are the same: • Early recognition of a change in an individual’s asthma condition. • Early intervention in an asthma flare. • Avoidance of treatment delays. • Minimization of the severity of flares. For the patient specifically, the goals of the AAP are also to increase confidence and security and to achieve self management. What are the Benefits of an AAP?
For the patient, an AAP— • Improves quality of life for the patient, family, and everyone involved in the patient’s care. • Provides a supportive provider/patient relationship that encourages questions and information exchange and leads to improved patient education. • Allows more control regarding self-care for the patient. • Early intervention shortens recovery from an
asthma flare. For the health care provider, an AAP— • Empowers the patient and builds trust between the patient and health care provider, which leads to improved quality of care. • Recognizes that the patient is an active participant in decision making, which leads to improved patient satisfaction. • Provides a time-efficient framework for each office visit, which leads to improved patient education. What are the Barriers for Creating and Following an AAP?
• Health care provider has not recognized or diagnosed the patient’s asthma. • Health care provider and/or patient does not value an AAP. • Patient does not accept the diagnosis of asthma. • Patient does not understand that asthma is a chronic disease. • Patient and/or health care provider believe that the symptoms are only seasonal and that an AAP is unnecessary. • Plan is written in a manner that it is difficult for patient to understand. • Health care provider and/or patient do not want to take the time for an AAP. • General lack of communication between health care provider and patient exists. A written AAP requires open communication on the part of both the health care provider and the patient. When patients are educated about their asthma and are given the resources to actively participate in controlling it, they will most often be healthier and have a better quality of life.
Mature Matters has been provided by
ASTHMA MAGAZINE
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F E AT U R I N G T O P I C S F O R A D U LT S W I T H A S T H M A
An Asthma Management Plan Is Important: Put It in Writing By Jan L. Tippett, RN, AE-C
Jan L. Tippett is a registered nurse and certified asthma educator practicing in Sacramento, Calif. Over the past decade, the focus of asthma management has switched dramatically from resolving acute asthma flares once they have occurred to preventing flares in the first place. Preventing asthma from flaring has become the main focus of health care delivery systems for patients with asthma. It is now recognized that the patient’s (or caretaker’s) active participation in the treatment process is essential for early intervention to prevent an episode of asthma from worsening. This also gives them a greater understanding of their illness and its management. Patients and their families are taught to recognize that treatment should be started at home to achieve maximum effectiveness and to avoid the increasing risk of uncontrolled symptoms and decreased quality of life. One means of educating patients and their families about asthma and increasing their role in the treatment process is to create a specific written plan of action for each patient. The
National Heart, Lung, and Blood Institute (NHLBI) guidelines of 1997 and the “2002 Update on Selected Topics” have embraced this approach and refer to this written plan as an asthma action plan (AAP). Think of your AAP as a road map to be followed by you and your health care professionals to help prevent and control asthma flares. The goal of the AAP is to tailor treatment for patients with asthma based on their current asthma condition—whether they are stable or experiencing an asthma flare. The written AAP should be developed through a process in which you and your health care providers collaborate to develop a personalized plan. Because asthma is a dynamic disease, the AAP, by definition, needs to be an ongoing process that is revised as the state of your disease changes. Changes in one’s condition can be brought on by any number of things, including respiratory infection, seasonal triggers, or a change in one’s environment. Who Needs a Written AAP?
The NHLBI recommends that all patients with asthma have a written AAP, regardless of the severity of their disease, which means that patients with mild disease or patients who only have seasonal symptoms should have an AAP. The AAP should help patients assess their actions when they are feeling well and help them
The written AAP should be developed through a process in which you and your health care providers collaborate to develop a personalized plan.
34
|
ASTHMA MAGAZINE
November/December 2004
recognize early warning signs or symptoms of worsening asthma. The AAP should direct stepped-up treatment with increased asthma symptoms and stepped-down treatment when the patient is feeling better. The AAP should be specific for each patient, based on a patient’s ability to monitor symptoms, access medical care, and understand his or her disease. In some cases, the plan may be as simple as, “If you notice these warning signs, call your healthcare provider,” or it could be detailed to cover medications that a patient may start taking at home. What are the Goals of a Written AAP?
The goals for the patient and the health care provider are the same: • Early recognition of a change in an individual’s asthma condition. • Early intervention in an asthma flare. • Avoidance of treatment delays. • Minimization of the severity of flares. For the patient specifically, the goals of the AAP are also to increase confidence and security and to achieve self management. What are the Benefits of an AAP?
For the patient, an AAP— • Improves quality of life for the patient, family, and everyone involved in the patient’s care. • Provides a supportive provider/patient relationship that encourages questions and information exchange and leads to improved patient education. • Allows more control regarding self-care for the patient. • Early intervention shortens recovery from an
asthma flare. For the health care provider, an AAP— • Empowers the patient and builds trust between the patient and health care provider, which leads to improved quality of care. • Recognizes that the patient is an active participant in decision making, which leads to improved patient satisfaction. • Provides a time-efficient framework for each office visit, which leads to improved patient education. What are the Barriers for Creating and Following an AAP?
• Health care provider has not recognized or diagnosed the patient’s asthma. • Health care provider and/or patient does not value an AAP. • Patient does not accept the diagnosis of asthma. • Patient does not understand that asthma is a chronic disease. • Patient and/or health care provider believe that the symptoms are only seasonal and that an AAP is unnecessary. • Plan is written in a manner that it is difficult for patient to understand. • Health care provider and/or patient do not want to take the time for an AAP. • General lack of communication between health care provider and patient exists. A written AAP requires open communication on the part of both the health care provider and the patient. When patients are educated about their asthma and are given the resources to actively participate in controlling it, they will most often be healthier and have a better quality of life.
Mature Matters has been provided by
ASTHMA MAGAZINE
to subscribe call 1.800.654.2452
|
35