• Beverley J Sheares, Robert B Mellins, Emily Dimango, Denise Serebrisky, Yuan Zhang, Michael R Bye, Mark E Dovey, Sami Nachman, Vincent Hutchinson, and David Evans.
• 1 Department of Pediatrics and.
• Am. J. Respir. Crit. Care Med.. 2015 Jun 15;191(12):1374-83.

RationaleAsthma clinical guidelines suggest written asthma action plans are essential for improving self-management and outcomes.ObjectivesTo assess the efficacy of written instructions in the form of a written asthma action plan provided by subspecialist physicians as part of usual asthma care during office visits.MethodsA total of 407 children and adults with persistent asthma receiving first-time care in pulmonary and allergy practices at 4 urban medical centers were randomized to receive either written instructions (n = 204) or no written instructions other than prescriptions (n = 203) from physicians.Measurements And Main ResultsUsing written asthma action plan forms as a vehicle for providing self-management instructions did not have a significant effect on any of the primary outcomes: (1) asthma symptom frequency, (2) emergency visits, or (3) asthma quality of life from baseline to 12-month follow-up. Both groups showed similar and significant reductions in asthma symptom frequency (daytime symptoms [P < 0.0001], nocturnal symptoms [P < 0.0001], β-agonist use [P < 0.0001]). There was also a significant reduction in emergency visits for the intervention (P < 0.0001) and control (P < 0.0006) groups. There was significant improvement in asthma quality-of-life scores for adults (P < 0.0001) and pediatric caregivers (P < 0.0001).ConclusionsOur results suggest that using a written asthma action plan form as a vehicle for providing asthma management instructions to patients with persistent asthma who are receiving subspecialty care for the first time confers no added benefit beyond subspecialty-based medical care and education for asthma. Clinical trial registered with www.clinicaltrials.gov (NCT 00149461).

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