The effectiveness of a pictorial asthma action plan for improving asthma control and the quality of life in illiterate women

Background: Written asthma action plans are an important part of asthma management, but cannot be used for illiterate people. Objective: The aim of this study was to establish the effectiveness of a pictorial asthma action plan on asthma control, health-related quality of life (HRQoL), and asthma morbidity in a population of illiterate women with asthma. Methods: Forty illiterate women with moderate-severe persistent asthma were assigned alternatively to receive either asthma education alone (control group) or asthma education and a pictorial asthma action plan (study group). Asthma control was assessed using the asthma control test (ACT), HRQoL was assessed using the St George's Respiratory Questionnaire (SGRQ), and the frequency of non-scheduled hospital or emergency visits was monitored. Results: Thirty-four patients completed the study. The ACT and SGRQ scores of both groups improved at every follow-up time point compared with baseline (p < 0.001). The ACT scores at 1 month (22.44 versus 20.75, p = 0.034) and 2 months (23.28 versus 21.81, p = 0.010) were higher in the study group than in the control group, but this was not maintained at 6 months (24.00 versus 23.25, p = 0.069). The SGRQ scores at 6 months were better in the study group (18.12) than in the control group (23.96, p = 0.033). No hospital admissions were recorded for either group. Conclusion: Education provides a significant improvement in asthma control and HRQoL while managing illiterate asthma patients, additionally the pictorial asthma action plan can be a helpful tool for self-medication.