Developing and communicating a long-term treatment plan for asthma

7The treatment of asthma, according to current guidelines, requires complex treatment regimens that change as clinical conditions improve or deteriora te. We have developed a practical way to communicate long-term treatment pl ans in chart form in the primary care setting that is easy for patients to follow and use. The chart has been an important element in two intervention s that have resulted in positive changes in health behavior and health outc omes in children with asthma. The plan provides recommendations for patient s and families to make adjustments in medication based on changes in sympto ms or peak expiratory air flow, or both, that are consistent with the Asthm a Guidelines Expert Panel Report 2, 1997. The plan also indicates when the number and dosage of drugs should be increased or decreased and when emerge ncy care should be sought, consistent with the Asthma Guidelines. By placin g considerable control in the family's hands and by clearly delineating the conditions under which medicines can be reduced or discontinued, the physi cian provides incentives for families to adhere to the longterm treatment p lan for asthma.