The impact of a structured consultation delivered by a respiratory nurse specialist on patients' use of personalised asthma action plans (PAAP)

Background: It is recommended that all people with asthma should be provided with written guidance in the form of a PAAP (NRAD 2014). NHS Lanarkshire recently produced an adult version of the PAAP and planned to assess its9 use in the local population. Methods: Patients with asthma were provided with a PAAP as part of a structured annual review and education program, delivered by a respiratory nurse specialist team as part of a collaborative project between NHS Lanarkshire and National Services for Health Improvement. Follow up telephone review was conducted at 6-months, when patients were asked the following questions: –Do you remember getting an PAAP? –Do you still have your PAAP? –When did you last look at your Asthma Management Plan? –Name one item it contains In addition, data on exacerbations and health care utilisation were collected. Results: 136 patients completed the project. At 6 month follow up, 82.2% remembered receiving their PAAP, 64.9% still had it, and 20.7% had used it. When asked to recall any one item it contained, 43.4% were unable to do so. During follow up, 27.2% of patients had one or more asthma exacerbations. Patients who had used their PAAP had poorer asthma control and were more likely to have had an exacerbation (50%) than those who had not used it (21.5%),p=0.004. Conclusions: Following a comprehensive asthma review with specific education around the importance of a PAAP, 6 months later, approximately one third of patients will not maintain it, and of those that do, a significant proportion will not be able to recall its content, which emphasises the importance that information must be written down for patients.