Improvement of quality of life in a family of a child with asthma after using the Written Asthma Action Plan (WAAP)

Abstract

ABSTRACT Background: Asthma is a common childhood disease that leads to impairment of quality of life (QOL) of both the children affected by the disease and their caregivers. Management of asthma includes pharmacotherapy along with education about asthma and its self-management, which is most often given verbally. There is limited evidence regarding the benefits of using a written asthma action plan (WAAP) that has been improved using pictorial representation. Objective: The study aimed to assess the effectiveness of a WAAP in improving the QOL of children with bronchial asthma and also of their caregivers. It also educates the patients and families about various triggers and danger signs of an acute attack of asthma. Methods: This was an interventional study with the aim of improving the quality of asthma management. Children of age group 7–17 years in whom the diagnosis of asthma was made and those parents and children who could read and answer the questionnaire (mini-PAQLQ and PACQLQ) were included in the study. Subjects were randomized into Case and Control groups. The intervention was to give the randomly selected patients (Case group) an individualized WAAP along with standard asthma care to both groups. Both groups were followed up to assess and record variations in the quality of life. Results: The P value was highly significant in the following parameters post-intervention: missed doses of controller medication (P value = 0.001), need for rescue medication (<0.001), ACT score (0.001), total PAQLQ (<0.001), and PACQLQ (<0.001) score. Though statistical significance was not established, improvement was also observed in the number of unscheduled OPD visits (P value = 0.082) and hospitalization events (P value = 0.554). Conclusion: On being provided with the WAAP, the frequency of acute asthma events, treatment compliance, and QOL improved. There was a significant increase in the primary outcomes-PAQLQ and PACQLQ scores. Significant improvement in the secondary outcomes-number of missed school days, missed doses of controller medication, need for rescue medication, and ACT score was also observed.