Development of a patient-centered asthma action plan for single maintenance and reliever therapy (MART)

Recent guidelines recommend maintenance and reliever therapy (MART) as the preferred inhaler regimen for patients with moderate to severe asthma. However, updated asthma action plans (AAPs), specifically tailored to MART, have not been developed for the US population.

We sought to design a MART-specific AAP that is accessible, pictorial, and low-burden for clinicians to use during time-constrained clinical encounters.

Together with health communication design experts, we used a multiphase, mixed-methods approach involving semistructured interviews with 7 adult patients with asthma and 6 clinicians at community health centers while exploring preferences for AAP content and design. Thematic analyses informed our design process, which used the 5E Design Thinking Framework. Our team ultimately developed 2 MART-specific AAPs and assessed their readability using a Flesch-Kincaid test.

Patients prioritized simple visuals, concise instructions, and clear guidance for managing worsening symptoms as key to a new MART-specific AAP. Clinicians emphasized the importance of time efficiency when completing AAPs. Using this feedback, we developed a 4" × 6" wallet-sized trifold AAP with a Flesch-Kincaid grade level of 3.7 specifically tailored for MART.

Because guidelines endorse MART as the preferred asthma therapy, new and updated MART-specific AAPs are important to facilitate optimal asthma care. Our team codesigned 2 MART-specific AAPs based on patient and clinician feedback.