Put it in writing! Home-management plan kept on paper helps control asthma

A new study confirms that adding an individualized, written home-management plan to a standard therapeutic regimen improves control of moderately persistent asthma in children. Sixty asthmatic children between 5 and 12 years of age, most of whom were receiving a moderate dosage of budesonide, completed the study. Investigators trained the subjects, and subjects' parents, to perform peak expiratory flow rate (PEFR) measurements and to maintain a diary of asthma symptoms in which they scored six variables: coughing, wheezing, difficulty breathing, missed school days, exercise intolerance, and use of rescue medication.

One group of children received the individualized, written home-management plan, based on assessment of asthma severity or PEFR; the other group did not receive such a plan. Both groups maintained standard asthma therapy, including education, during the study period, with follow-up every week during the first month and monthly for the next three months. At follow-up visits, investigators assessed disease parameters, such as any acute asthma events since the last visit, and recorded the patient's symptom score.

Compared with children who did not have a written home-management plan, those who had a plan had significantly fewer acute asthma events, lost fewer school days, and awoke at night less often. In addition, children who had a plan had far lower overall symptom scores (Agrawal SK et al: Acta Paediatrica 2005;94:1742).

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