Ducharme Francine M, Bhogal Sanjit K
Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, 2300 Tupper Street, Montreal, Canada.
Curr Opin Allergy Clin Immunol. 2008 Apr;8(2):177-88. doi: 10.1097/ACI.0b013e3282f7cd58.
The aim of this article is to examine the evidence for the effectiveness of a written action plan as an important element of guided self-management and to identify key features associated with its effectiveness in children and adolescents.
Various written action plans are available for use; however, few have been specifically designed or validated for children. Strong, but limited pediatric evidence confirms that the addition of a written action plan to guided self-management education significantly improves outcome. Use of daily controller medication, with no step-up therapy other than as needed inhaled beta2-agonist, best prevents asthma exacerbations. Symptom-based appear superior to peak-flow based written action plans. The paucity of pediatric trials does not permit the identification of other keys features that enhance the dispensing of written action plans by healthcare professionals or uptake of recommendations by children, adolescents and their parents.
Written action plans are effective tools to facilitate self-management. While step-up therapy is not superior to daily controller medication, symptom-based are superior to peak-flow based action plans for preventing exacerbations, other keys features associated with effectiveness have yet to be identified.
本文旨在探讨书面行动计划作为指导自我管理重要组成部分的有效性证据，并确定与儿童和青少年有效性相关的关键特征。
有多种书面行动计划可供使用；然而，专门为儿童设计或验证的却很少。有力但有限的儿科证据证实，在指导自我管理教育中加入书面行动计划可显著改善结果。使用每日控制药物，除按需吸入β2激动剂外不进行升级治疗，最能预防哮喘发作。基于症状的书面行动计划似乎优于基于峰值流速的计划。儿科试验的匮乏使得无法确定其他能提高医疗保健专业人员发放书面行动计划或儿童、青少年及其父母接受建议的关键特征。
书面行动计划是促进自我管理的有效工具。虽然升级治疗并不优于每日控制药物，但基于症状的行动计划在预防发作方面优于基于峰值流速的计划，其他与有效性相关的关键特征还有待确定。
