Effects of a written asthma action plan on caregivers' management of children with asthma: a cross-sectional questionnaire survey.

Abstract

Background: Caregivers of children with asthma provided with a written asthma action plan (WAAP) are reported to be more confident in their ability to provide care for their child during an asthma exacerbation. However, little is known about how a WAAP impacts on their care processes that contributed to this increased confidence.

Aims: To determine the effects of a WAAP on caregivers' understanding of asthma symptoms, their use of asthma medications for their children, and acute care visits to consult their physicians.

Methods: A questionnaire survey to caregivers of children with a WAAP (CW) and without a WAAP (CNW) who were followed up at nine public primary care clinics in Singapore. χ(2) test was used to determine the differences in outcomes between the CW and CNW groups, followed by logistic regression to adjust for potential covariates.

Results: A total of 169 caregivers were surveyed (75 CNW, 94 CW). Caregivers in the CW group were more likely to understand bronchoconstriction (adjusted odds ratio (AOR) 4.51, p=0.025), to feel capable (AOR 2.77, p=0.004), safe (AOR 2.63, p=0.004), and had increased confidence (AOR 2.8, p=0.003) to change doses of inhaled medications during an asthma exacerbation. The CW group perceived inhaled asthma medication to be safe (AOR 3.42, p=0.015) and understood the use of controller medication (AOR 3.28, p=0.006). No difference was noted between caregivers in their likelihood to stop medications without consulting their physician, seek acute care consultation, and confidence in self-management of their children's asthma at home.

Conclusions: The WAAP improved caregivers' understanding of the disease and use of inhaled asthma medications during asthma exacerbations but did not affect their decision regarding acute visits to their physician.