title: Does self-management prevent severe exacerbations?
abstract: OBJECTIVE
  Despite effective therapies, asthma outcomes remain suboptimal. Education in self-management is crucial to maintaining control in a variable condition such as asthma and reducing the risk of severe asthma exacerbations, hospitalizations and deaths. This review considers the evidence for supported self-management.
  
  
  RESULTS
  Recent systematic reviews have clarified and confirmed the major benefits from effective self-management education, but have also shown that implementation is rare in routine practice, with consequent avoidable morbidity and mortality. Recent research has focused on the most effective ways of delivering and supporting self-management in different patient groups and has clarified the relative effectiveness of the different components. Self-management support using new digital technologies has been investigated.
  
  
  CONCLUSIONS
  All clinicians treating patients with asthma should be supporting their patients to understand and manage their own condition. Optimal self-management incorporates education, provision of a personalized asthma action plan and is supported by regular professional review. Action plans in a written or digital format should advise on recognizing deterioration and the actions to take, including when to seek professional help, appropriate changes in medication dose or commencing rescue oral steroids. Action plans should be personalized and agreed by the patient, and provided in a culturally tailored form.
authors.affiliation: aAsthma UK Centre for Applied Research, Allergy and Respiratory Research Group, Centre for Population Health Sciences, University of Edinburgh, Edinburgh bPrimary Care and Population Sciences, University of Southampton cNIHR Southampton Respiratory Biomedical Research Unit dNIHR Wessex Collaboration for Leadership in Applied Health Research and Care (CLAHRC), Southampton, UK.
authors.forename: Hilary
authors.initials: H
authors.lastname: Pinnock
authors.forename: Mike
authors.initials: M
authors.lastname: Thomas
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D018450:Disease Progression; D055317:Evidence-Based Practice; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D057285:Precision Medicine; D012648:Self Care / Q000523:psychology
chemical_list: D018927:Anti-Asthmatic Agents