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PAMP: pictorial asthma medication plan for pacific children

PAMP: pictorial asthma medication plan for pacific children

Asthma and Pacific children

Asthma is a major cause of many New Zealand children being hospitalised.  Children from Pacific communities are more likely to have asthma and their acute symptoms are often more severe when compared with other groups.  Pacific children are more likely to be admitted to hospital for preventable asthma.

Uncontrolled asthma can have a big impact on children and their families' lives, for example children may be unable to attend school or may not be able to participate in sport.

What are we trying to achieve?

Value: Everyone MattersEvidence suggests that Pacific families may not understand how to use asthma medicines and how to recognise the signs and symptoms of worsening asthma.  These factors might contribute to poor asthma management and symptom control.

We wanted to create an asthma education for Pacific families that reinforced the key messages about regular ‘everyday’ inhaler use and how to recognise the warning signs of asthma. The aim was to reduce the high rate of asthma-related hospital admissions.


What have we done?

Our Quality Use of Medicines team worked with staff and patients at West Fono Health Trust in Henderson, Auckland, along with clinicians from paediatric nursing, pharmacy and medical staff at the Rangitira Children’s Unit at Waitakere Hospital.  We developed a personalised, pictorial asthma medication plan in English and in three Pacific Island languages - Samoan, Tongan and Tuvaluan.

Focus groups comprising of West Fono staff and patients helped to refine the resources and  with writing the resources in the first languages.  We concentrated on producing simple, colourful resources using a 'less-is-more' approach.  The text is kept to a minimum and includes plenty of pictures, because many people reported being turned off by written resources if they contained large amounts of text.  The focus of the Pacific Asthma Medication Plan, or PAMP, is on the child’s ‘everyday’ inhalers.

Personalised asthma plans in 4 languages
Personalised asthma plans in 4 languages

Asthma warning signs & symptoms in 4 languages
Asthma warning signs and symptoms in 4 languages

The team also developed a website that creates individualised asthma medication plans - www.pamp.co.nz.  Health professionals can use the website to produce a personalised PAMP for their patients.  Pre-printed information sheets about the signs and symptoms of asthma are also available in the patient's first language.  These resources are laminated together and are attached with fridge magnets for families to take home.

PAMP website- www.pamp.co.nz
PAMP website for creating individualised asthma medication plans - www.pamp.co.nz


Did we make a difference?

The team undertook a year-long study of 48 Pacific families to find out:

  • whether the resources were usable and acceptable to Pacific families
  • how effective the PAMP was in reinforcing the importance of ‘everyday’ inhalers and to act as a reminder to use them regularly
  • whether using the PAMP resources resulted in a change in the pattern of ‘everyday’ inhaler use
  • how effective the asthma signs and symptoms sheets were in informing and improving self-management

The study team looked at whether the resources were still being used after six months.


Results

The results of the study were published in the New Zealand Medical Journal[1]The study found that the resources were acceptable and helped to educate families effectively.

  • PAMP was effective at reinforcing the importance of ‘everyday’ inhaler use and as a reminder for regular use.
  • Signs and symptom sheets were also informative and improved self-management.
  • First language versions of PAMP were well used by Pacific families.
  • The majority of families found the design and layout acceptable.

Nearly all the families who trialed PAMP reported that the pictures of their child's asthma inhalers acted as a reminder to use the inhalers on a routine basis, which is what the PAMP team set out to achieve.

  1. Kristiansen J, Hetutu E, Manukia M, Jellyman T. An evaluation of a pictorial asthma medication plan for Pacific Children. NZMJ 11 May 2012, Vol 125 No 1354. [View NZMA article online]

 

Where to from here?

  • You can create a PAMP and provide feedback to the Quality Use of Medicines Team on the PAMP website - www.pamp.co.nz.
  • The PAMP, or Pictorial Asthma Medication Plan, is now being promoted nationwide for use in all ethnicities and many health providers are currently using it.
  • The next step is to provide the plans in Te Reo Māori and Chinese.