![]() Two controlled trials using validated pictorial action plans have yielded contrasting findings 21, 22. have developed a validated pictorial asthma action plan that was comprehensible in three different populations of asthma patients, including Malaysia 20. Several studies have reported pictorial asthma action plan for use in adults 20, 21, 22. An action plan that provides guidance in a pictorial format has the potential to overcome inequities 15, 16, 17, 18 for people with limited literacy and numeracy skills by making complex health information easier to comprehend 19, and beneficial 20. However, in Malaysia, about 60% of adults with asthma have limited health literacy challenging use of traditional text-based plan 14. Asthma action plans are an integral component of supported self-management in which patients are given written advice on how to adjust their treatment according to changes in their disease status 9, 10, 13. Despite this, asthma is not a healthcare priority in Malaysia compared to other non-communicable diseases (cardiovascular diseases and diabetes) and is relatively underfunded 8.Īll major national and international asthma guidelines recommend asthma self-management that is personalised to patients’ preferences and views 9, 10 to improve clinical outcomes and reduce healthcare costs 11, 12. Only a third of people with asthma attend regular follow-up care with low usage of controller medications and overuse of oral short-acting beta-agonist 5, 6, 7. Annually in Malaysia, 68% of people with asthma visit their doctor 50% attend emergency department, and 10% are admitted, this representing substantial morbidity and incurring substantial emergency healthcare costs 3, 4. Most asthma-related deaths occur in low- and middle-income countries 2. Īsthma affects almost 300 million people globally and 100 million people in Southeast Asia 1, 2. Trial registration number: ISRCTN87128530 prospectively registered: September 5, 2019. Supported self-management with a pictorial asthma action plan was associated with an improvement in asthma control and potential cost savings in Malaysian primary-care patients. Estimated savings for the 59 patients at 6-months follow-up and for each patient over the 6 months were RM 15,866.22 (USD3755.36) and RM268.92 (USD63.65), respectively. The proportion achieving good asthma control increased from 18 (30.4%) at baseline to 38 (64.4%) at 6-month follow-up. About 84% ( n = 59/70) completed the 6-months follow-up. We estimated potential cost savings on asthma-related care following plan use. Secondary outcomes included reliever use, controller medication adherence, asthma exacerbations, emergency visits, hospitalisations, days lost from work/daily activities and action plan use. The primary outcome was asthma control, assessed at 1, 3 and 6 months. We adapted an existing pictorial asthma action plan. We conducted a pre–post feasibility study among adults with physician-diagnosed asthma on inhaled corticosteroids at a public primary-care clinic in Malaysia. This paper is on a feasibility study, and observing the change in clinical and cost outcomes of pictorial action plan use is part of assessing feasibility as it will help us decide on outcome measures for a fully powered RCT. Supported self-management reduces asthma-related morbidity and mortality. Npj Primary Care Respiratory Medicine volume 32, Article number: 34 ( 2022) Feasibility of supported self-management with a pictorial action plan to improve asthma control
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