A mailed personalised self-management plan improves attendance and increases patients' understanding of asthma.

Abstract

To evaluate postal prompts to increase patients' understanding and use of self-management plans (SMP). A single-blinded randomised controlled trial in 545 adults with asthma prescribed an inhaled corticosteroid. The control group were mailed an invitation for a medical review. The second and third groups were mailed invitations with a blank or a personalised written action plan respectively. Outcomes were whether patients had a review, felt they knew how to use SMP, and the self reported 'Royal College of Physicians three questions' score of current morbidity ('RCP score'). Compared to the control group, prompts with a personalised written action plan resulted in more patients having a review of their care (odds ratio 2.33, 95% CI 1.37 to 3.93) and understanding how to use their SMP (odds ratio 2.20, 95% CI 1.13 to 4.30). Prompts with a blank written action plan resulted in more reviews (odds ratio 1.92, 95% CI 1.18 to 3.11) but no difference in understanding how to use their SMP (odds ratio 1.28 95% CI 0.66 to 2.45). Reviews carried out: 70% vs 82% vs 84% for groups 1, 2 and 3 respectively; understanding how to use a SMP: 40% vs 46% vs 59% for groups 1, 2 and 3 respectively. There was no difference in reported 'RCP scores' between the three groups. Personalised prompts increased frequency of review and patients understanding of SMPs but SMPs remain underused.