Written asthma action plans are one of the most effective asthma interventions available.
An integral part of asthma management is the development of a written asthma action plan by the person with asthma and/or their carer together with their doctor.
An asthma action plan helps the person with asthma and/or their carer recognise worsening asthma and gives clear instructions on what to do in response.
To view and download templates, go to our Asthma Action Plan Library.
The process of developing a written asthma action plan is important, as this should be a discussion of the person’s individual asthma and its management. The written plan is a reminder of that discussion.
Written asthma action plans are one of the most effective asthma interventions available. Use of a written asthma action plan:
- reduces absences from work or school
- reduces hospital admissions
- reduces emergency visits to general practice
- reduces reliever medication use
- improves lung function.
Doctors should consider developing a written asthma action plan when discussing asthma management with all people with asthma and/or their carers.
The aim of an asthma action plan is to help the person with asthma and/or their carer take early action to prevent or reduce the severity of an asthma attack.
The asthma action plan may be based on symptoms and/or peak expiratory flow (PEF) measurements and is individualised according to the pattern of the person’s asthma. In children, symptom-based plans are preferred.
Once completed, the asthma action plan is given to the person with asthma and/or their carer to keep. Parents should give a copy of their child’s asthma action plan to the school, pre-school and/or childcare facility.
Regular review of the asthma action plan is important as a person’s level of asthma severity or control may change over time.
What should a written asthma action plan include?
Different asthma action plans suit different people, but all plans should have the same essential features. The plan should:
- be in a written format
- be individually prescribed, rather than a general example
- contain information that allows the patient and/or their carer to recognise exacerbations (flare-ups)
- contain information on what action to take in response to those exacerbations.
Basic details should include the date, the patient’s name, and their doctor’s contact details. Some also include contact details for the patient’s carer or emergency contact person.
Many plans follow a traffic light system for assessing the severity of exacerbations, moving from green for ‘under control’ to red for ‘emergency’.
Whichever system is used, the response plan needs to cover:
- Maintenance/preventer therapy: doses and frequencies of regular medications
- Treating exacerbations: how to adjust treatment in response to particular signs and symptoms
- Managing increased severity: when to start oral corticosteroids and seek medical advice
- Danger signs: when and how to seek urgent medical help
Peak expiratory flow (PEF) measurement
Inclusion of PEF measurements in the asthma action plan can be beneficial for people with more severe or difficult-to-control asthma, and those who are not readily aware of symptoms of limited airflow.
When PEF is used, the asthma action plan should be based on personal best rather than on predicted values. Care should be taken when increasing treatment for falls in PEF if there are no symptoms, as there is a risk of over-treatment.
PEF measurement is not recommended for children under 12 years. In most children with asthma, change in symptoms is as effective as PEF for indicating that asthma is getting worse.
A small number of people with asthma may benefit from long-term PEF monitoring. For more information and a PEF chart template go to Peak Flow Chart.
Action plans for anaphylaxis, allergic reactions and eczema
The Australasian Society of Clinical Immunology and Allergy (ASCIA) has developed a range of action plans for anaphylaxis, allergic reactions and eczema. Having an anaphylaxis action plan is particularly important for people at risk of serious allergic reactions.
The action plans are available from the ASCIA website:
- Anaphylaxis and allergic reactions action plans
- Eczema action plans
More Information
Global Initiative for Asthma. Global strategy for asthma management and prevention 2014. Available from: www.ginasthma.org
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From: Psychological Interventions in Asthma
| British Thoracic Society (BTS)/Scottish Intercollegiate (SIGN) | British guideline on the management of asthma October 2014 | “Initiatives to promote adherence to regular treatment should consider… behavioural support, e.g., regular monitoring including assessment of medication use with feedback, counselling, psychological therapies” Patients with severe asthma and one or more adverse psychosocial factors are at risk of death. |
| Global Initiative for Asthma (GINA) | Global strategy for asthma management and prevention August 2014 | Major psychological problems identified as a potentially modifiable independent risk factor for exacerbations. Treatment strategy for those with major psychological problems “arrange mental health assessment, help patient distinguish between symptoms of anxiety and asthma; provide advice about management of panic attacks”. “Information alone improves knowledge but does not improve asthma outcomes. Social and psychological support may also be required to maintain positive behavioural change, and skills are required for effective medication delivery”. “Cognitive behavioural therapy has been described as having some potential in patients with asthma; however, current evidence is limited with a small number of studies and methodological shortcomings”. “Psychological interventions may be helpful in patients with severe asthma” |
| European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force | International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma April 2014 | “Unfortunately, the benefit of psychiatric treatment on asthma outcomes has not been well established and a recent Cochrane meta-analysis evaluating psychological interventions involving various relaxation and behavioural techniques both in adults and children was not able to find firm benefit of these interventions on asthma outcomes.” |
| Canadian Thoracic Society | Canadian Thoracic Society 2012 guideline update: Diagnosis and management of asthma in pre-schoolers, children and adults | N/A |
| National Heart Lung and Blood Institute | Guidelines for the Diagnosis and Management of Asthma November 2007 | Psychosocial problems or psychiatric disease identified as a risk factor for asthma-related death |