Every person with asthma should have their own written Asthma Action Plan (WAAP).
When provided with appropriate self-management education, self-monitoring and medical review, individualised WAAP consistently improve asthma health outcomes if they include two to four action points and provide instructions for use of both inhaled corticosteroid and oral corticosteroids for treatment of attacks/flare-ups. WAAPs are effective if based on symptoms or personal best peak expiratory flow (not on percentage predicted).
How to develop and review a written asthma action plan
For every person with asthma, develop an individualised WAAP that is appropriate for their treatment regimen, asthma severity, culture, language, literacy level, and ability to self-manage. Ensure each person has prescriptions for medications to treat their asthma. The WAAP should be developed in partnership with the patient.
A WAAP should include all the following:
- A list of the person’s usual medicines (names of medicines, doses, when to take each dose) – including treatment for related conditions such as allergic rhinitis or sleep apnoea
- Clear instructions on how to change medication (including when and how to start a course of oral corticosteroids) in all the following situations:
- When asthma is getting worse (e.g., when needing more reliever than usual, waking up with asthma, more symptoms than usual, asthma is interfering with usual activities)
- When asthma symptoms get substantially worse (e.g., when needing reliever again within 3 hours, experiencing increasing difficulty breathing, waking often at night with asthma symptoms)
- When peak flow falls below an agreed rate (for those monitoring peak flow each day)
- During an asthma emergency.
- Instructions on when and how to get medical care (including contact telephone numbers)
- The name of the person writing the action plan, and the date it was issued (Gibson & Powell 2004).
Templates for WAAPs
Templates are available from:
Peak flow monitoring is no longer routinely used in Australia, but is recommended for patients with severe asthma, a history of frequent attacks/flare-ups, or in people who poorly perceive their symptoms and airflow limitation.
For persons who are willing to measure peak flow regularly, morning and evening readings can be plotted on a graph or recorded in a diary. This objective measure is based on a persons’ personal best value and enables detection of flare ups more easily. The peak flow values are then incorporated in the persons’ individual written Asthma Action Plan (WAAP).
For more information, visit https://www.asthmahandbook.org.au/management/adults/self-management/action-plans