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新的基于证据的工具,用于指导成人哮喘行动计划的制定。

New evidence-based tool to guide the creation of asthma action plans for adults.

机构信息

Clinical fellow in the Division of Respirology in the Department of Medicine at the University of Toronto in Ontario.

Chair of the Board of Directors for the Family Physician Airways Group of Canada and Clinical Lecturer in the Department of Family and Community Medicine at the University of Toronto.

出版信息

Can Fam Physician. 2019 Feb;65(2):103-106.

Abstract

OBJECTIVE

To improve the use of asthma action plans (AAPs) among primary care physicians.

SOURCES OF INFORMATION

In a 2017 article, recent asthma guidelines and adult studies (January 2010 to March 2016) addressing acute loss of asthma control were reviewed to develop an evidence-based tool to help guide physicians in creating AAPs to maximize adherence and minimize errors. Evidence supporting the effects of AAPs is level I. Evidence supporting the recommendations in the tool ranges from level I to consensus.

MAIN MESSAGE

A lack of knowledge about and training in creating appropriate AAP content is an important barrier to the use of AAPs, as is the fact that instructions provided by asthma guidelines are often difficult to integrate into real-world practice. In order to address these issues, a freely accessible, practical, evidence-based tool has recently been created, addressing both the knowledge and the practical barriers to AAP creation. This tool has been formatted as a printable bedside chart for the point of care, but could also be integrated into a computerized electronic decision support system in the future.

CONCLUSION

Asthma action plans, in conjunction with asthma education and regular follow-up, can improve patients' symptoms and quality of life and reduce hospitalization. This novel point-of-care tool provides practical advice on how to complete AAPs to improve patients' asthma self-management.

摘要

目的

提高初级保健医生对哮喘行动计划(AAP)的使用。

信息来源

在 2017 年的一篇文章中,回顾了最近的哮喘指南和成人研究(2010 年 1 月至 2016 年 3 月),以制定一个基于证据的工具,帮助医生制定 AAP,以最大限度地提高患者的依从性,减少错误。支持 AAP 效果的证据为一级。支持该工具中建议的证据范围从一级到共识。

主要信息

缺乏制定适当 AAP 内容的知识和培训是使用 AAP 的一个重要障碍,哮喘指南提供的说明通常难以整合到实际实践中也是一个障碍。为了解决这些问题,最近创建了一个免费、实用、基于证据的工具,既解决了知识方面的问题,也解决了制定 AAP 的实际障碍。该工具已被格式化为可在床边打印的图表,以便于使用,但将来也可以整合到计算机化的电子决策支持系统中。

结论

哮喘行动计划,结合哮喘教育和定期随访,可以改善患者的症状和生活质量,减少住院。这种新的床边工具提供了关于如何完成 AAP 以改善患者哮喘自我管理的实用建议。

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本文引用的文献

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Solving the mystery of the yellow zone of the asthma action plan.解开哮喘行动计划黄色区域之谜。
NPJ Prim Care Respir Med. 2018 Jan 11;28(1):1. doi: 10.1038/s41533-017-0067-1.
3
Personalised asthma action plans for adults with asthma.针对成年哮喘患者的个性化哮喘行动计划。
Cochrane Database Syst Rev. 2017 Apr 10;4(4):CD011859. doi: 10.1002/14651858.CD011859.pub2.
7
Chronic disease management programmes for adults with asthma.针对成年哮喘患者的慢性病管理项目。
Cochrane Database Syst Rev. 2015 May 27;2015(5):CD007988. doi: 10.1002/14651858.CD007988.pub2.

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