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    A personalised asthma action 

      A personalised asthma action plan (also known as a treatment plan) is a written plan designed by you and your healthcare professional that provides instructions on how to control you or your child’s asthma.1

       

      Because everyone’s asthma symptoms and triggers maybe different, the action plan should be personalised or customised to the individual’s asthma. Contact your healthcare professional and set up an appointment to develop an asthma action plan for yourself or your child.

       

      Before you start managing asthma, it is important to understand a little more about you or your child’s asthma. What are your early warning signs, symptoms, and triggers? This information should be recorded in a diary or an asthma app. Keep a diary either on paper or electronically to record the following:

      Common asthma triggers

       

      Triggers may be unique to each individual who has asthma.2 Common triggers include:

       

      • Viruses such as a cold or flu
      • Allergens such as pollen, dust mites, mold spores, pet dander
      • Physical activity (exercise-induced asthma)
      • Cold air
      • Air pollutants and irritants, such as smoke
      • Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
      • Strong emotions and stress
      • Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
      • Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat

       

      It is important to track not only trigger exposure, but also if symptoms occur1 so that you and your healthcare professional can develop a trigger control plan. This would be useful information to help you and your healthcare professional to not only identify asthma triggers but the information may be used to develop a trigger control plan. These personal triggers and control plan for management of triggers should be listed on the asthma action plan. Managing your indoor air quality may help in managing allergens and triggers.

      Asthma triggers

      Symptoms and early warning signs

      It will also be helpful to identify symptoms and early warning signs. Examples of symptoms are waking at night, coughing, wheezing, chest tightness, or shortness of breath during exercise. Symptoms are also unique to each person. Not all individuals who have asthma wheeze. In some cases, the only symptom may be a cough3. The asthma action plan should have a place to list personal symptoms and step-by-step instructions regarding how to manage symptoms.

      Peak flow readings

      The peak flow reading is a measure of how fast you can blow out the air in your lungs using a peak flow meter. Just like triggers and symptoms, a peak flow reading may be unique to anyone who has asthma. Therefore, when using a peak flow meter it is important to determine you or your child’s personal best peak flow reading. A personal best peak flow reading is the highest reading that can be achieved when asthma is controlled. To determine personal best, measure peak flow readings for two weeks twice a day, write these down in a peak flow chart and share these readings with your healthcare professional. Because different peak flow meters may provide slightly different readings, it is important you use the same peak flow meter.  Your healthcare professional can use these readings to determine you or your child’s personal best peak flow reading. They can then create a personalised asthma action plan for you. This reading will be used by your healthcare professional to help develop a personalized written asthma action plan.

      Understanding the zones in an asthma action plan


      The three zones of asthma management are part of an asthma action plan. The zones are a simple colour-coded system to help patients and parents of children with asthma to recognise the severity of asthma symptoms and changes in peak flows, so that they can use their asthma medications at the right time and deliver the correct amount of medication. The instructions in the zone system are set up like a traffic light which makes it simple to understand.
       

      Your healthcare professional may use the information you recorded in your diary regarding asthma triggers, peak flow readings, symptoms and early warning signs to develop a personalised written asthma action plan using the zone system.  He or she will teach you to use the zone system to assess the severity and frequency of asthma symptoms, changes in peak flow readings and how to follow their instructions for use of asthma medications.

       

      The zones and written instructions from your healthcare professional will be laid out in the asthma action plan like a traffic light:

       

      Green means that asthma is in good control. You or your child are symptom-free and peak flow readings are 80-100% of the personal best reading. You can GO ahead with regular activities. In the green zone, the medication instructions provide details how to take daily controller medications.

      Yellow means symptoms are present, peak flow readings are 50-80% of personal best reading. You should proceed with CAUTION. The yellow zone, contains instructions regarding how often to use the reliever medications and when to call your healthcare professional.

      Red means that you or your child are having severe symptoms and peak flow readings are less than 50% of personal best reading. You should STOP and get medical attention. The red zone contains instructions regarding the immediate use of reliever medications and instructions to call the healthcare professional immediately or alternatively to call 999.

      PersonalBest peak flow meter zones


      Many peak flow meters have zone indicators that can be set by the healthcare professional on the peak flow meter. Once these are set, the indicator will point to the green, yellow or red zone which will allow you to quickly evaluate where your or your child’s peak flow reading fall within the zones.  You can then refer to the written personalised asthma action plan and follow the instructions provided by your healthcare professional for how to take asthma medications.

      Zona verde

      Green zone

      Peak flow meter green zone
      Zona amarilla

      Yellow zone

      Peak flow meter yellow zone
      Zona roja

      Red zone

      Peak flow meter red zone

      Why is an asthma action plan so helpful

       

      Still not sure exactly how an action plan makes such a difference. You can use it to:
       

      • pinpoint the signs that show your asthma’s getting worse, so you can get help quickly and cut your risk of having an asthma attack2
      • understand when and how to take your medicine to keep your asthma well managed
      • get on top of your asthma again if you haven’t been using your controller inhaler as prescribed
      • be sure what to do if you have an asthma attack2
      • monitor your asthma day to day2
      • let your friends and family know what to do in an emergency – show your action plan to those closest to you2
      • check when your next review is due2
      • keep a note of your healthcare professional's contact number.2

      What if my asthma changes - won't the plan go out of date?

       

      Your asthma action plan should be reviewed and updated at least once a year at your asthma review with your doctor.1 You need to remember to take it with you to every asthma appointment - including any emergency or consultant visits - so that if there are any changes to the way you need to look after your asthma, your plan can be updated. It is also useful for hospital staff to be able to glance at the information in your action plan, especially if you are finding it difficult to talk due to your symptoms.2

      Be prepared

       

      Keep a list of emergency contact numbers. It is important to list the healthcare professional's phone number and emergency phone numbers on the action plan. If the action plan is for your child, make sure you list your mobile phone number.

       

      Preparation is the key to success. Once you have a personalised asthma action plan, put a plan in place for using it.

       

      Keep the action plan in a handy place so you can act quicklyKeep a copy in a readily available place in your home – such as posted on your refrigerator. Just like the reliever medication make sure you have a copy with you when you travel away from home. Keep a copy in your purse, backpack or wallet so you can have immediate access to it.

       

      Review it with all that are involved in care. This includes your entire family members so they know what to do in case of an emergency. If the action plan belongs to your child, provide a copy to the schools and review it with your child’s teachers and coach.

       

      Keep the action plan up-to-date

      Asthma symptoms, triggers and medications may all change over time. Keep regular check-ups with the healthcare professional and adjust the action plan as needed.

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      DISCLAIMER:
      Information on this website is informational only and should not replace the advice of a physician.

      FOOTNOTES:
      [1] mayoclinic.org/diseases-conditions/asthma/in-depth/asthma/art-20044888. Accessed October 2017.

      [2] asthma.org.uk/advice/manage-your-asthma/action-plan. Accessed October 2017.

      [3] Webmd.boots.com. Asthma/guide/asthma-symptoms. Accessed Nov 2017.

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