Self-Management of Asthma improves patient quality of life, reduces symptoms and visits to Accident and Emergency.
Asthma affects 334 million of us Worldwide. In the UK we take-up 6 million appointments with our GPs and 100,000 of us are admitted to hospital via A&E as a result of this long-term condition.
Even more tragically, 1,468 people died from asthma attacks in the UK in 2015, an increase of 21% compared with the previous year (1,212) according to the UK’s National Offices of Statistics. Yet worse, many of these deaths could have been prevented. Sadly, only 23% of those who died had received formal education on how to manage their asthma and a staggering 43% had not sought or received medical attention in their final attack.
Researchers in Scotland have recently published the results of a “study of studies” compiling research from 277 separate investigations involving thousands of patients involved in a range of Self-Management plans, which are developed in collaboration with their healthcare professionals (called a Self-Management Care Pathway).
Self-Management is where we learn how to better manage our asthma, what our triggers are, what to do as our symptoms worsen, how to measure these objectively, what medication we need to have to control and prevent symptoms and how we get medical support to keep us up-to-date and on the right meds for us. This information is summarised in our Personal Action and Care Plan and every asthmatic should have one.
The researchers of this report (Systematic meta-review of supported self-management for asthma: a healthcare perspective) provides a series of key facts, supported with evidence, of how those of us with asthma can better self-manage our condition:
• Self-Management works. It reduces the severity of our symptoms which gives us a better quality of life. It reduces the likelihood that we will be rushed to A&E with an asthma attack. It saves the NHS money by not taking-up emergency services when our hospitals are struggling.
• Asthmatics with a written Care and Action Plan are four times LESS LIKELY to have to go to A&E as a result of our asthma (Asthma UK).
• Self-Management costs money to implement, but the savings of not using A&E or being admitted to hospital more than pay for the costs.
The Self-Management ethos must be taken seriously by all those involved: patients, the healthcare professionals treating us in our hospitals or in the community, policy makers, those that pay for health services locally (Commissioners), employers and teachers at school.
The researchers identified six key elements that make a good Care and Action plan for those of us with asthma. It can be boiled down to some simple actions:
• Education. The more educated we have about our asthma, the fewer emergency treatments in hospital we use. We need to learn what to do, why and when.
• Tools: We need to see when our symptoms are getting worse. Using symptom scores and measuring lung function with a Peak Flow monitor improves the measurement control in both adults and children (over 5yrs) so that we can detect when our symptoms are getting worse.
• Triggers: Knowing what triggers our asthma and how to avoid them.
• Medication: What medication prevents our symptoms, what medications do we take to relieve symptoms and which of our medications do we need to take if symptoms continue to get progressively worse.
• Behaviour change: Our attitude to taking our medications as they are supposed to be taken can be a huge challenge and all of us need to work on this.
• Regular medical reviews: To make sure we are using our inhalers correctly, are on the right medication and dose for us and to update our Action and Care Plan.
None of these six steps are hard to do. But we need to learn, plan, develop our monitoring skills and act on the instructions in our plan.
Simple to do and could save our life or the life of those we care about.
The full research paper can be downloaded for free here:
Systematic meta-review of supported self-management for asthma: a healthcare perspective. Hilary Pinnock et al. BMC Medicine201715:64 Published: 17 March 2017. Accessed online 22/3/17 http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0823-7