Table 2

Summary of the key components of a written personalised asthma action plan

Component of an action planResultPractical considerations
Format of action points
 Symptom versus peak flow triggeredSimilar effectAsthma UK personalised asthma action plans include both symptom triggers and peak flow levels at which action should be taken.
 Standard written instructionsConsistently beneficial
 Traffic light configurationNot clearly better than standard instructions
Number of action points
 2–3 action pointsConsistently beneficialThree commonly used action points are:Peak flow <80% best: increase inhaled steroidsPeak flow <60% best: commence oral steroids and seek medical advicePeak flow <40% best: seek urgent medical advice.
 4 action pointsNot clearly better than 2–3 points
Peak flow levels
 Based on percentage personal best peak flowConsistently beneficialPersonal best should be assessed once treatment has been optimised and peak flows are stable. Best peak flow should be updated every few years in adults, and, if a peak flow meter is being used, more frequently in growing children.
 Based on percentage predicted peak flowNot consistently better than usual care
Treatment instructions
 Individualised using inhaled and oral steroidsConsistently beneficialPatients may safely hold an emergency supply of prednisolone tablets for use if their symptoms continue to deteriorate and/or if their peak flow falls to 60% of their best.
 Individualised using oral steroids onlyInsufficient data to evaluateIncreasing inhaled steroids is ineffective if patients are already taking moderate or high doses (≥400 µg daily) and these patients should be advised to move straight to the oral steroid step.
 Individualised using inhaled steroidsInsufficient data to evaluateThose on low doses (e.g. 200 µg) of inhaled steroids may be advised to increase the dose substantially (e.g. to 1200 µg daily) at the onset of deterioration. Patients who have stopped medication should be reminded to restart their inhaled steroids.
  • Reproduced from [8] with permission from the publisher.