Ouksel H, Pineau A
Unité d'éducation thérapeutique, pôle Hippocrate, service de pneumologie, 4, rue Larrey, 49933 Angers cedex 9, France.
Unité d'éducation thérapeutique, pôle Hippocrate, service de pneumologie, 4, rue Larrey, 49933 Angers cedex 9, France.
Rev Mal Respir. 2021 Apr;38(4):372-381. doi: 10.1016/j.rmr.2021.02.063. Epub 2021 Mar 26.
The Written Action Plan is a tool designed to help people with asthma to manage their condition when they experience an exacerbation. Asthma guidelines are consistent in their recommendation that action plans are useful for all people with asthma, but implementation is not systematic. The evidence base for such plans is limited because of methodological biases, but does support their effectiveness. The recommended action plan involves different color-coded zones which advise patients to adjust their management, such as increasing the level of daily treatment, or introducing oral corticosteroids based on symptoms and peak expiratory flow measurements. Recommendations are much less clear as to how to encourage patients to adopt and take ownership of their plan, although they all recommend that written action plans be incorporated into therapeutic education programs. The published literature shows that those caring for people with asthma may not support action plans because they are uncomfortable with the necessary educational posture and as a consequence of this they are under-utilized by patients. Patient-centered therapeutic education principles help us understand both how to encourage the patient want to have a written action plan and how to co-create it with them so that it is useful and meaningful in their life in order to make it more than just a disconnected tool.
书面行动计划是一种工具，旨在帮助哮喘患者在病情加重时控制病情。哮喘指南一致推荐行动计划对所有哮喘患者都有用，但实施并不系统。由于方法上的偏差，此类计划的证据基础有限，但确实支持其有效性。推荐的行动计划包括不同颜色编码的区域，建议患者调整管理方式，如增加日常治疗水平，或根据症状和呼气峰值流量测量结果使用口服皮质类固醇。关于如何鼓励患者采用并自主管理其计划，建议则不太明确，尽管所有指南都建议将书面行动计划纳入治疗教育项目。已发表的文献表明，照顾哮喘患者的人可能不支持行动计划，因为他们对必要的教育方式感到不自在，因此患者对其利用不足。以患者为中心的治疗教育原则有助于我们理解如何鼓励患者想要制定书面行动计划，以及如何与他们共同制定，使其在他们的生活中有用且有意义，而不仅仅是一个脱节的工具。
