The NHS 2007-08 asked all respondents whether they had ever been told by a doctor or nurse that they have asthma, whether symptoms were present or they had taken treatment in the 12 months prior to interview, and whether they still had asthma. Those who answered yes to these questions were asked whether they had 'a written asthma action plan, that is, written instructions of what to do if your asthma is worse or out of control'. A very small number of respondents who were sequenced around these questions may have reported current long-term asthma in response to later general questions about medical conditions. These persons are included in and contribute to estimates of the prevalence of asthma, but information about written action plans was not collected from them. In the 2004-05 NATSIHS, non-remote respondents who answered yes to the questions about having asthma were asked about written asthma action plans. In both the 2004-05 NHS and NATSIHS, respondents were asked simply if they had 'a written asthma action plan'. If they queried the interviewer about what to include, they were told to include management plans developed in consultation with a doctor, cards associated with peak flow meters and medication cards distributed through chemists. In 2007, if respondents queried the interviewer, they were asked to include plans that were worked out in consultation with a doctor, but not cards associated with peak flow meters or medications cards handed out by chemists. Ideally this indicator would relate to the proportion of people with moderate to severe asthma, as people with only very mild asthma are unlikely to require planned care. Consequently, there is no clear direction of improvement in this indicator: a lower proportion of people with asthma with an asthma care plan may simply mean that those people with asthma have less severe asthma (which would actually be a positive outcome). |