Characteristics of Patients and Providers Utilizing Asthma Action Plans in the AAAAI Asthma IQ Program

Evidence-based guidelines support the use of asthma action plans (AAPs) for asthma self-management and education despite ongoing controversy on improving outcomes. We sought to evaluate the patient and provider characteristics associated with having an AAP. We examined data from 28,508 de-identified patients documented in the Asthma IQ database to determine current AAP use in relationship to provider type (primary care vs. asthma specialist), patient characteristics (age, race, smoking history) and comorbid conditions (rhinosinusitis, GERD, depression and obesity). Descriptive statistics were performed and Chi-square tests used to examine associations. We determined odds ratios of current AAP use for each characteristic/comorbidity. 36% of children and 34% of adults with persistent asthma had a current AAP. Patients seen by an asthma specialist were more likely to have an AAP compared to those seen by a primary care physician (Child OR: 1.7, 95% CI:1.3-2.1; Adult OR: 1.8, 95% CI: 1.5-2.4). Children with rhinosinusitis (OR: 1.3; 95% CI: 1.1-1.7; p<0.05) and African American children (OR: 1.5; 95% CI 1.1, 2.0; p<0.05) were more likely to have a current AAP. Adults that were younger (OR: 0.99; 95% CI: 0.98-0.99; p<0.05), obese (OR: 1.6; 95% CI: 1.2-2.1; p<0.05) or had depression (OR: 2.1; 95% CI: 1.2-3.6; p<0.05) were more likely to have a current AAP. AAPs were more commonly used by asthma specialists and prescribed to patients with characteristics that have been previously shown to be associated with poor asthma outcomes. Programs such as Asthma IQ might facilitate the appropriate use of AAP in higher risk patients.