Action plans, self-monitoring and adherence: changing behaviour to promote better self-management.

Abstract

What we know: Patient self-management improves asthma outcomes. The key features of self-management are having a written asthma action plan, monitoring asthma symptoms and seeking regular review. Self-management is an important goal. Doctors can learn how to improve patient self-management. Multiple attitudinal barriers limit adherence to asthma preventers, especially inhaled corticosteroids in children. Appointment reminders improve clinic attendance. Poor adherence with the asthma treatment regimen is common. Simplification of the healthcare regimen is associated with better adherence. What we need to know: What is it about a written action plan that is the key to its effect? Is it mostly useful for managing acute asthma exacerbations or is it also useful for day-to-day management in the longer term? How can broader implementation of action plans be achieved in Australia? How can appointment reminders be incorporated into regular medical care? How can we modify patient attitudinal and knowledge barriers to preventer medication? How can we improve compliance with asthma preventer medication?