The Uptake of Physician Approved Written Asthma Action Plans: A Mixed Methods Study
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2013-01-25
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Abstract
This mixed methods study aimed to evaluate implementing a simple intervention to increase Written Asthma Action Plan (WAAP) possession by patients with asthma. The intervention included health care professionals (HCPs) providing WAAPs and basic teaching to patients with asthma. For the qualitative component of the study, HCPs were interviewed to explore their experiences with implementing the WAAP in their practice; a thematic analysis was used to analyze the data. For the quantitative component, patients that were provided with the WAAP were assessed at baseline and again 6 months later. The primary quantitative outcome of interest was the possession of a physician approved WAAP by the individual with asthma, secondary outcome included asthma control. In Phase 1, six sessions of interviews were conducted over 3 months. Seventeen HCPs participated in the interviews, with 1 to 7 participants in each interview session. HCPs were overwhelmingly positive about the WAAP and stated it was a valuable tool for educating patients and demonstrating the criteria for asthma control. They felt qualified to complete the WAAP and expressed confidence in completing the yellow zone of the plan. HCPs that were successful at implementing the intervention had physician colleagues that were supportive. Several barriers to implementation were discovered. Most notably, asthma was a low priority for chronic disease management. HCPs did not receive referrals for asthma patients, and identifying patients with asthma was challenging. Additionally, time was a barrier to implementation, as HCPs identified it was challenging to find time to provide education to patients, particularly when addressing other health concerns. In Phase 2, the intervention resulted in an association between the provision of a WAAP template by a health care professional and rate of physician approved WAAP possession 6 months following the intervention. The mean score for the Asthma Control Questionnaire increased significantly 6 months post intervention; however, it did not reach the level of clinical significance. The findings of this study suggest that community based HCP can dispense WAAPs that receive physician approval. However, in order for HCPs to provide WAAPs, significant barriers, particularly the low priority of asthma in chronic disease management and time to provide education, need to be addressed.
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Sharpe, H. (2013). The Uptake of Physician Approved Written Asthma Action Plans: A Mixed Methods Study (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/28408