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How to Choose an Asthma Booklet

This rating scale was developed with input from the nation's top asthma experts. (read report) If you would like us to rate your current booklet, mail it to: Rating Booklets, Pedipress, Inc.,125 Red Gate Lane, Amherst MA 01002.

Rating Asthma Booklets

“Asthma self management education is essential to provide patients with the skills necessary to control asthma and improve outcomes.”(1) Effective teaching will save time and improve your patient’s understanding during the visit and beyond. Your teaching will be easier if you use an effective asthma booklet everywhere patients are waiting to be seen or need to be educated: in the waiting room, exam room, ER, hospital ward, pharmacy, in group sessions and at home. A booklet is superior to a single page handout because most patients are ready to learn more about their illness.

The 2007 NHLBI Guidelines (EPR-3) does not tell how to choose an asthma booklet. However, ten independent asthma experts agreed that patients need knowledge in ten basic areas in order to achieve optimal asthma control. (2) Each of these areas has three parts. Use the chart (Fig.1) to compare booklets that you are considering for your practice. Score 3 if only the first part of an area is present. Score 6 if the first two parts are covered. Score 10 only if all three parts are covered.

An effective booklet will score at least 90 points. Of the more than more than 30 booklets I have rated, only One Minute Asthma (OMA) scored more than 49. You can use the chart below to compare booklets that you are considering for your practice.

Patients who read the inside front cover of OMA will learn how well they could feel when their asthma is well controlled. These patients will expect their providers to work with then to achieve good control. As a result, their need for emergency care and hospitalizations will drop.

Most free or cheap booklets will force your staff to spend their valuable time teaching basic information. A good booklet will pay for itself many times over in staff time saved and improved asthma control (reduced costs for ER and hospital care).

(1) Expert Panel Report – 3 Guidelines for the Diagnosis and Management of Asthma. NIH Publication, Bethesda, MD: U.S. Department of Health and Human Services; National Institutes of Health; National Heart, Lung, and Blood Institute; National Asthma Education and Prevention Program, 2007. P. 93

(2) Plaut, TF.Basic Elements of Education for Childhood Asthma, American Journal of Asthma & Allergy for Pediatricians 1991; 4:220-222.
Sets Proper Expectations for Well Controlled Asthma Explains Devices for Inhaling Asthma Meds
3
 Fully active
3
 Describes use of a metered dose inhaler, dry powder inhaler, holding chamber, compressor driven nebulizer
6
 Symptoms 2 days a week or less
6
 Gives proper instruction for four of five devices
10
  Wake at night 2 times a month or less
10
 Gives proper instruction for all five devices
Describes Signs of Asthma Explains the Asthma Reaction
3
  Cough, wheeze, retraction and increased respiratory rate
3
 Inflammation and bronchoconstriction
6
 Scores each sign
6
 Accurate illustration
10
 Lists emergency signs
10
 Hyper-reactivity
Discusses Triggers Presents an Asthma Diary
3
 Defines a trigger
3
 Sample diary
6
 Lists: pollutant, allergen, viral, cold air, exercise
6
 Displays peak flow zones graphically
10
 Discusses avoidance and that the effects of triggers add up
10
 Tracks peak flow, medicines, asthma signs and triggers
Explains Peak Flow Monitoring Presents an Asthma Action Plan
3
 Recommends home use
3
 Plan shows asthma care zones
6
 Provides instructions
6
 Presents clear example of zone management
10
 Explains peak flow zones
10
 Covers daily and emergency asthma situations
Describes Asthma Medicines Tells How to Choose a Provider
3
 Presents concepts of quick relief and controller medicines
3
 Gives printed instructions
6
 Presents good and bad effects of inhaled steroids, leukotriene modifiers, short and long acting beta agonists and oral steroids
6
 Observes use of all devices prescribed
10
 Lists generic and brand names
10
 Checks air flow (peak flow, FEV1 or PFT) at each visit

Fig.1

The top score for each item is 10. It requires that items 3 and 6 are also present. The score for an area is reduced to 0 if there is a error. A complete and comprehensive asthma booklet will earn a total score over 90. The two blank columns are for rating other booklets.
Name
One Minute Asthma (3)
Expectations
10
Signs
10
Triggers
10
Peak Flow
10
Medicines
10
Devices
10
Asthma Reaction
10
Diary
10
Action Plan
10
Choice
10
TOTAL SCORE
100
Grade Level
5
Languages
English, Spanish
(3) Plaut, TF, One Minute Asthma: What You Need to Know, 8th edition, Pedipress, Inc., 2008.

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