Intended for healthcare professionals


Guided self management plans for asthma

BMJ 2001; 322 doi: (Published 05 May 2001) Cite this as: BMJ 2001;322:1121

Advice should be simple and patient focused

  1. Martyn Partridge, consultant chest physician,
  2. Greta Barnes, director,
  3. David Price, professor of primary care respiratory medicine,
  4. Jack Barnes, director of Research and Policy
  1. Chest Clinic, Whipps Cross Hospital, London E11 1NR
  2. National Asthma and Respiratory Training Centre, Warwick CV34 4AB
  3. General Practice Airways Group, Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Aberdeen AB25 2AY
  4. National Asthma Campaign, London N1 0NT
  5. Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Aberdeen AB25 2AY
  6. Department of Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand
  7. Royal Australian College of General Practitioners, WA Research Unit, Shenton Park, Western Australia 6010, Australia
  8. University of Wales College of Medicine, Gorseinon General Practice Research Unit, Swansea SA4 2US
  9. Department of General Practice, University of Wales College of Medicine, Health Centre, Cardiff CF23 9PN
  10. School of Social Science and International Development, University of Swansea, Swansea SA2 8PP

    EDITOR—The study of Jones et al on the views of health professionals and patients about guided self management plans for asthma may be open to misinterpretation.1 They conclude from exploratory work with focus groups that attempts to introduce self guided management plans for asthma in primary care are unlikely to be successful—a conclusion unsupported by evidence.

    Patients are managing their own care but without help from healthcare professionals, a finding that is supported by recent interviews undertaken by the National Asthma Campaign, which showed significant asthma morbidity and only 6% of patients recalling any kind of written advice on how to take asthma treatment.2 An Australian study found greater use of self management plans in primary care.3

    What the research of Jones et al tells us is the size of the problem involved in encouraging some asthma nurses and primary care doctors to take on the challenge. But in the light of the evidence, we should not be daunted by that task.4 We need to empower, rather than simply seek to educate, patients. We need to overcome the belief that self management plans are complex (it is unclear from the paper what complexity of self management was portrayed to the study participants). And additional barriers—that self management is not appropriate for most patients and the belief that education alone is the key to success—are also not supported by evidence.5

    The “Be in Control” initiative that was launched by the National Asthma Campaign on 30 January 2001 is designed to make self management easier for busy healthcare professionals. It should meet the plea from doctors and asthma nurses in the study who believe that advice should be simple and patient focused rather than simply generic.

    As far as patients are concerned, we see nothing new in …

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