Understanding asthma action plan promotion and use: what the qualitative evidence tells us

Citation

Ring NA, Hoskins G, Jepson R, Wilson C, Wyke S, Pinnock H & Sheikh A (2010) Understanding asthma action plan promotion and use: what the qualitative evidence tells us. International Primary Care Respiratory Group Research Conference , Toronto, 02/06/2010 - 05/06/2010. Primary Care Respiratory Journal, 19 (2) p. A15. http://www.theipcrg.org/display/DoResearch/Past+Abstracts

Abstract
Aim: To understand what helps or hinders asthma action plan promotion by health professionals and use by patients/parents. Method: Systematic review and synthesis of qualitative studies. Relevant studies were identified through database searches with potentially relevant papers assessed against study criteria. Included studies were qualitative and provided insight into what facilitates or prevents the promotion and use of asthma action plans. Included studies were synthesized using metaethnography, a process which brings individual studies together into a new ‘line of argument'. Results: Nine databases were searched (April 2009) and 20 papers met our inclusion criteria. Participants did not see asthma action plans as universally helpful or relevant. Action plan implementation involves complex decision-making influenced by many factors. Findings suggest action plan implementation is hindered because patients/parents and professionals operate within different asthma models which inform their understandings of the condition, its management and their roles. Barriers to action plan implementation are symptomatic of these different asthma models. Findings reinforce the need to involve those with long-term conditions in their care. If professionals provide medically focused action plans that do not ‘fit' with the patients'/parents' views of asthma and its management, action plans will continue to be perceived as irrelevant and under-used. Facilitators, including communication, are required so action plans can be jointly developed by patients/parents and professionals. Conclusion: Meta-ethnography allowed novel insights into the synthesised studies. Findings strengthen the importance of professionals adopting a patient-centred, partnership approach to the development and review of action plans, recognising the place of asthma in patients' everyday lives. Conflict of interest and funding: No conflict of interest. Funding: Chief Scientist's Office for Scotland.

Journal
Primary Care Respiratory Journal: Volume 19, Issue 2