ZAAP Asthma Cards Development of an idea from concept to the finished product

Zoned Asthma Action Plan (ZAAP) Credit card sized action plan for those with asthma User assesses severity of current symptoms using the card Placed in one of four colour zones with corresponding actions Action tells person how to optimise treatment – keep themselves safe

Problem which led to development Studies show only 5% of asthma sufferers carry an action plan Delayed treatment may contribute to worsening asthma  May lead to worsening morbidity or even mortality

The challenges in development Finding funding for research in a primary care setting Finding an organisation to audit the asthma card Designing an audit suitable for a primary care setting

The benefits to patients and staff The card is applicable to both children over 5yrs and adults It establishes a common language and understanding between health professional and the patient with asthma Clinician: “what zone are you in?” Patient: “Orange” Clinician: “how did you come to that decision” Patient: “my blue reliever is less effective and I am using it 4 times a day”

The benefits to patients and staff Evidence shows that early treatment with oral steroids in deteriorating asthma reduces the need for hospital admission – the card prompts this course of action in the Orange zone Patients know when it is safe to reduce the dose of inhaled steroids, based on an agreed plan with their nurse or doctor e.g. “Step down steroid inhaler once you have been in the Green zone for 3 months” Supports DOH strategy by enabling patients to manage their own long term conditions ZAAP card is discrete and possibly more acceptable to young patients

Development timeline 2002 Considering how the management of asthma may be improved 2003 First prototype produced and trialled in own practice 2004 Card revised and used in local surgeries 2005 Approached by East Midlands Innovation Hub offering support to disseminate asthma card 2006 Trialled in different centres (primary and secondary care) across the Midlands 2007 Search for sponsors to fund audit and validation of asthma card 2009 Project supported by grant from Nene Commissioning 2009 Audit by Northampton University in progress

The pilot study / audit Started Feb 2009 Geoff White (Project Facilitator) Dr. Jackie Parkes (Project Manager) Working in 1 practice in Towcester with 2 Nurse Practitioners 18-25yrs age range originally, now rolled out to include full caseload

Review with Project team + Dr. Findlay Audit form reviewed 460+ cards sent by post, telephone consultation as back-up Due for analysis in August ’09 Final report Sept ’09 Dissemination countywide The pilot study / audit

Tips to other innovators Go with your gut feeling especially if you have work experience in the area of innovation Be realistic about timescales Be prepared to develop your concept on the basis of feedback Be prepared to go back to the drawing board but enjoy the process nonetheless Subject your concept to rigorous scrutiny and objective validation

Contact Name: Dr James Findlay Base of work: Rushden Medical Centre Adnitt Road Rushden NN10 9TR Telephone: or

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