Creating a Personal Asthma Action Plan

Why a Written Plan Is Worth Having

Most people with asthma can tell you roughly how they are doing, but "roughly" is not much help at three in the morning when your chest is tight and you are not sure whether to wait it out or call for help. A personal asthma action plan removes that guesswork. It is a short written record, usually a single side of A4, that sets out exactly what your medicines are, how to tell when your control is slipping, and what to do at each stage.

Plans work because asthma changes. A chest infection, a run of cold mornings, high pollen, or a new pet in the house can all shift your symptoms within days. Because a plan is written down, you do not have to rely on memory or on how you felt at your last review six months ago. You simply read it and follow it. Evidence consistently shows that people with a written plan have fewer attacks, fewer hospital admissions, and more confidence in managing their own condition.

If you do not have one, ask your GP surgery for a personalised asthma action plan at your next review. They are free, and completing one is a normal part of good asthma care.

What Goes Into Your Plan

Almost all UK action plans use a simple traffic light system. Your own plan will be filled in with your personal numbers and medicines, but the structure is usually like this:

• Green – you are well. No cough, wheeze, chest tightness or breathlessness. You sleep through the night and can do your usual activities. Your peak flow, if you use a meter, is at or near your personal best. Keep taking your preventer inhaler every day, exactly as prescribed, even when you feel fine.
• Amber – your control is getting worse. You may be waking at night, needing your reliever inhaler more than usual, coughing or wheezing with exercise, or your peak flow has dropped. The plan will tell you what to increase, and for how long, before you seek advice.
• Red – you need urgent help. Your reliever inhaler is not lasting four hours, you cannot speak in full sentences, you are breathing fast, or your peak flow has fallen well below your usual level. This section tells you to take your reliever inhaler as directed, and to call 999 or go to your nearest emergency department.

Your plan should also list your preventer and reliever inhalers by name and dose, your personal best peak flow figure, your trigger avoidance advice, and the phone number of your GP surgery.

Filling It In With Your GP or Nurse

An action plan only works if it matches your actual asthma, so it is worth completing it properly rather than accepting a blank template. Book a routine asthma review and take a few things with you: your current inhalers, your spacer, a note of how often you have used your reliever in the past month, and any peak flow readings you have recorded.

Ask the nurse or GP to check your inhaler technique while you are there, ideally with a spacer if you use one. Poor technique is one of the most common reasons asthma control drifts, and it is easily fixed in a five-minute demonstration. This is also the moment to agree your personal best peak flow, if you use a meter, and to write down the specific numbers that separate each zone. Vague advice such as "come back if you get worse" is far less useful than "if your peak flow falls below 380, start the amber steps."

Using It Day to Day

A plan is not a document to file away. Keep a copy somewhere you will actually see it: on the fridge, in your phone, or in the bag you take to work. If your child has asthma, make sure their school or nursery has a copy, along with a spare reliever inhaler and spacer.

Get into the habit of a quick daily check. Are you using your reliever more than three times a week? Waking at night? Struggling on stairs or during sport? Any of these means you are in amber territory, and it is time to act rather than wait. Many people put off stepping up treatment because they hope it will settle, then end up unwell. The plan is there to give you permission to act early.

When Things Go Wrong

In the red zone, speed matters more than anything else. Take your reliever inhaler as your plan directs, usually one puff every 30 to 60 seconds up to a maximum of ten puffs, using a spacer if you have one. Sit upright, stay calm, and do not delay calling 999. If you are unsure and things are not yet severe, NHS 111 can advise you, but never let a phone call replace emergency help when you clearly need it.

After any attack or flare-up, book a review with your GP or nurse within a few days. Your plan will almost certainly need adjusting, and your preventer dose may need to be stepped back up temporarily.

Reviewing and Updating Your Plan

Aim for at least one asthma review a year, and sooner if anything changes. Your plan needs updating if your medicines change, if your peak flow personal best shifts, if you move house or surgery, or if you have had an attack. Children's plans should be reviewed more often, since doses and inhaler devices change as they grow.

Write the date on your plan each time it is reviewed, and replace the old copy rather than keeping both. Give your family, housemates or partner a quick look at it too, so they know what to do if you are unable to speak for yourself. A plan that everyone around you understands is a plan that works.