An asthma action plan is a personalised document prepared with your healthcare provider that describes the features of your asthma and includes information on how to best treat your asthma symptoms before they get worse. It is a crucial tool with which to manage your asthma and to improve control.
The information about your asthma may be divided in three areas, green, yellow and red, which correspond to the level of severity of your symptoms as asthma worsens. In each area you will find the actions to take, including medicines, instructions on when to take them, for example if you need to take a reliever medicine before exercise, the proper use and dosage, and information about when to seek medical help and your emergency contact. The action plan may also include which vaccinations you should have and when.
Be sure you are fully confident about the content of the action plan of the person you are taking care of, and keep your own copy of it so that you can act quickly in case of an emergency!
Action plans will vary from person to person. Below are examples of what an action plan may include.
GREEN AREA
The green area means your asthma is “doing well” and treatment (controller and reliever) should be continued as always.
Action plans often say you are in this area if:
- You need to use your reliever inhaler less than three times per week
- You don’t wake up with asthma
- Your activities (including exercise) are not limited due to asthma
- Peak flow reading (if used) is in your normal zone. Your doctor will tell you what level is normal for you
YELLOW AREA
The yellow area means your asthma “is getting worse” and it may be necessary to “step-up” the maintenance therapy for 1–2 weeks. Sometimes your doctor may ask you to take a short course (5–7 days) of prednisone or prednisolone tablets.
Action plans often say you are in this area if:
- You need to use your reliever inhaler more often than usual
- You often wake up with asthma
- You have to limit normal activities (including exercise)
- Peak flow reading (if used) is lower than your normal. Your doctor will tell you what the yellow zone level is for you
RED AREA
The red area means “medical alert” and this when you should contact a doctor or go to the emergency department
Action plans often say you are in this area if:
- You need to use your reliever inhaler more often than every 3-4 hours or if it has no effects
- You continuously wake up with asthma
- You are getting worse quickly or are having difficulty speaking because of your breathing
- Peak flow reading (if used) is much lower than your normal. Your doctor will tell you what the red zone level is for you
Review your asthma treatment according to the plan
The plan is tailored to your needs and applies only to you. By referring to three areas (green, yellow and red) you will know which situations and symptoms you should monitor in order to adapt your treatment without consulting the doctor, and when it is necessary to contact the doctor to review your treatment.
A different type of action plan will be used depending on whether you are prescribed an anti-inflammatory reliever (e.g., budesonide-formoterol or beclometasone-formoterol) or a SABA reliever. The plan should include instructions for increasing your reliever, and how much you can take, and whether you should increase your controller medication, and for how long.
Keep the asthma action plan updated
- You should regularly see your healthcare provider to update your written asthma action plan.
- You are the leading actor of your action plan, include here and in your daily asthma journal everything you think is useful, including considerations about your lifestyle.
- If you suffer from other conditions that may require immediate action, the action plan should also include the actions to be taken in case of an emergency not due to asthma. For example, if you have a history of anaphylaxis, the plan should include the need to keep your epinephrine pen with you at all times together with instructions on how to use it.
Daily asthma journal
Having asthma should be one more reason to take care of yourself and to learn how to listen to your body and needs. A daily asthma journal allows you to record on a day-by-day basis how your asthma is going and also to record any questions or doubts you may have about your treatment. A daily asthma journal can be a precious tool for some patients, since filling it in can instil in you a sense of discipline about your health. It is also useful to communicate with your healthcare provider and to work together to control your asthma.
In your journal you can:
- Track your symptoms, when they appear and when they bother you most, such as:
- The type of symptoms and the time of the day in which they appear
- The circumstances in which you have symptoms most often, for example, at night, in the morning, after being active, or at certain times of year
- Compare your symptoms with the areas on your asthma action plan and take steps as-needed
- Identify any potential trigger that seems to worsen your asthma, such as
- Any respiratory infection you get, even if mild
- Symptoms related to exposure to tobacco smoke, air pollution, pollen, etc.
- Take note of your medicines, such as
- Keep track of the medicines you use for sudden asthma attacks and how often you use them
- After you start or change a medication, note how the new treatment affects your asthma
- Effects of any vaccination you get
- Record your peak flow measurements and the results of your lung function test (if used)
- Monitor your lung function at home using a peak flow meter and record the results in your journal
- Compare your peak flow readings with the areas on your asthma action plan and take steps as-needed
- Write down information about your daily life
- Any major stress you experience
- Recent lifestyle changes
Keep the daily asthma journal updated
- Keep a digital version of your journal on your mobile device calendar so that you will always have it with you!
- Keep a copy of your written asthma action plan together with your diary, so that you can assess in which area you are and act accordingly.
- Pay particular attention to your symptoms when you change environment, for example during travel.