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Canadian Respiratory Journal
Volume 15 (2008), Issue 7, Pages 347-354
Original Article

Two for One: A Self-Management Plan Coupled with a Prescription Sheet for Children with Asthma

Francine M Ducharme,1,2 Francisco Noya,3 David McGillivray,4 Sandy Resendes,5 Stéphanie Ducharme-Bénard,5 Roger Zemek,6 Sanjit Kaur Bhogal,5 and Rachel Rouleau7

1Clinical Research on Childhood Asthma, University of Montreal, Canada
2Department of Pediatrics, University of Montreal, Canada
3Division of Allergy and Clinical Immunology, McGill University Health Centre, Canada
4Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children’s Hospital, McGill University Health Centre, Canada
5Division of Pediatrics, Research Centre, CHU Sainte-Justine, Montreal, Quebec, Canada
6Division of Pediatric Emergency Medicine, Department of Pediatrics, Children’s Hospital for Eastern Ontario, Ottawa, Ontario, Canada
7Quebec Network for Asthma and COPD Education, Department of Pharmacy, Centre de Santé et de Services Sociaux de la Vieille Capitale, Quebec City, Quebec, Canada

Copyright © 2008 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Despite strong recommendations in the asthma guidelines, the use of written self-management plans remains low among asthmatic patients.

OBJECTIVES: To develop a written self-management plan, based on scientific evidence and expert opinions, in a format intended to facilitate its dispensing by health care professionals, and to test the perception of its relevance and clarity by asthmatic children, adolescents and adults.

METHODS: Inspired by previously tested self-management plans, surveys of asthma educators, expert opinions and the 2004 Canadian Asthma Guidelines, the authors simultaneously developed French and English versions of a written self-management plan that coupled with a prescription. The self-management plan was tested in parents and their asthmatic children (aged one to 17 years), and it was revised until 85% clarity and perceived relevance was achieved.

RESULTS: Ninety-seven children and their parents were interviewed. Twenty per cent had a self-management plan. On the final revision, nearly all items were clear and perceived relevant by 85% or more of the interviewees. Two self-management plans were designed for clinics and acute care settings, respectively. The plans are divided into three control zones identified by symptoms with optional peak flow values and symbolized by traffic light colours. They are designed in triplicate format with a prescription slip, a medical chart copy and a patient copy.

CONCLUSION: The written self-management plans, based on available scientific evidence and expert opinions, are clear and perceived to be relevant by children, adolescents and their parents. By incorporating the prescription and chart copies, they were designed to facilitate dispensing by physicians in both clinics and acute care settings.