Written Asthma Action Plans (WAAPs) in Melbourne general practices: a sequential mixed methods study

Aim: To investigate ownership and perceived utility of written asthma action plans (WAAPs) in general practice. Methods: Questionnaires were completed by 225 adults and 75 children with GP-diagnosed asthma from 31 practices. Regression models for WAAP ownership allowed for confounders and clustering by practice. Five audio-recorded focus groups were conducted before questionnaire implementation and, 12 months later, six focus groups and additional in-depth interviews with 29 patients and 16 doctors were conducted. Transcripts were submitted to content and thematic analyses. Results: A total of 37% of adults and 47% of children had WAAPs. Adults reporting spontaneous shortness of breath, an emergency presentation in the previous 12 months, or frequent GP visits were more likely to have a WAAP. Qualitative data indicated that few acknowledged receipt or use of one. Those who remembered receiving a WAAP found it useful in asthma management in conjunction with verbal advice given by their GE WAAPs were perceived by some patients as an indicator of doctor competence which, in turn, was viewed as signifying better management of asthma by the patient even if the WAAP was never actually used. Conclusions: Ownership of WAAPs is still low. Additional and more effective strategies are required to improve rates of GP prescription of WAAPs. (C) 2011 Primary Care Respiratory Society UK. All rights reserved. N Sulaiman et al. Prim Care Respir J 2011; 20(2): 161-169 doi: 10.4104/pcrj.2011.00010