Using a Comprehensive Approach for Asthma Education and Action Planning

Abstract

Purpose: This quality improvement (QI) project aimed to increase utilization and documentation of written asthma action plans, spirometry testing, and education for asthma patients in a family primary care practice. The project’s intervention consisted of provider focused education on current asthma guidelines and making a standardized written asthma action plan (WAAP) available. Background: Asthma prevalence continues to rise with an estimation of 43.12 million new cases and 490,000 deaths annually. Currently, in the Unites States (US), there is approximately 38% of children and 50% of adult asthma patients suffering with uncontrolled asthma. The total 20- year national direct cost of uncontrolled asthma is about 300.6 billion dollars. Gaining control of asthma requires supported self-management from healthcare providers to help patients learn strategies to control their disease, improve quality of life, and reduce emergency room visits, hospitalizations, and healthcare costs. Methods: The use of multiple Plan-Do-Study-Act (PDSA) cycles was used in this QI project. A pre-survey was sent to all providers to measure for provider awareness and current asthma practice. A chart audit was also completed, then an education intervention provided. After the intervention and post-survey the chart audit was used to compare results and determine effect. Results: Over eight weeks, WAAP charting increased from 10.0% to 31.3% post-intervention and spirometry increased from 26.7% to 49.57%. Asthma education handouts also increased after intervention from 56.7% to 83.48%. Surveys found that providers felt their knowledge of asthma, guidelines, and medications increased post-intervention. There was also a notable increase in perceived provider confidence and preparedness in providing asthma education and action plans. Conclusion: Provider education improved compliance with asthma guidelines including asthma action plan utilization, education handouts, and spirometry testing. It also increased provider knowledge, confidence, and preparedness in caring for asthma patients. Limitations of this project included small sample size and difficulty discerning intervention effectiveness due to anonymity of participants. However, this project provides novel information that could improve clinical practice and could be generalized for management of other chronic diseases.