Endgames Case Review

Self management for a man with asthma

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h3970 (Published 24 July 2015) Cite this as: BMJ 2015;351:h3970
  1. Hilary Pinnock, reader1,
  2. Stephanie J C Taylor, professor of public health and primary care2
  1. 1Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh EH8 9AG, UK
  2. 2Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, UK
  1. Correspondence to: H Pinnock hilary.pinnock{at}ed.ac.uk

A 35 year old man with a history of asthma attended the practice asthma clinic a few weeks after an acute exacerbation. He was a non-smoker who had asthma as a child but “grew out of” the more troublesome symptoms in his teens. He regards his asthma as well controlled, although his computer record suggested that he has had six short acting bronchodilator inhalers in the past year. He is more troubled by hay fever, which he manages with antihistamines that he buys from the pharmacy. He has a sedentary lifestyle so avoids exercise induced symptoms. He has a repeat prescription for an inhaled steroid (which he takes “when he needs it”) and carries a salbutamol inhaler with him in case he experiences any chest tightness. Despite annual invitations to the asthma clinic he last attended six years ago.

A month ago, a high pollen count triggered a severe asthma attack that necessitated attendance at the emergency department. This event had interrupted the family camping holiday and delayed his return to work. He was shaken by the episode, and his wife and employer had both encouraged him to attend the nurse led asthma clinic to find out what could be done to prevent a recurrence.

Questions

  • 1. What are the potential benefits of providing this man with self management education and a written personalised asthma action plan?

  • 2. What are the three key pieces of information that should be incorporated into an asthma action plan?

  • 3. What additional information will be needed to personalise the information for this man?

  • 4. Who in the primary healthcare team is responsible for providing and supporting asthma self management?

Answers

1. What are the potential benefits of providing this man with self management education and a written personalised asthma action plan?

Short answer

Education on self management, including a written personalised asthma action plan supported by regular professional review, improves asthma control and reduces unscheduled consultations for asthma emergencies. …

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