ABSTRACT
Background@#A written asthma action plan (WAAP) is one of the treatment strategies to achieve good asthma control in children. @*Methods@#This randomized controlled trial was conducted to observe the effect of WAAP on asthma control and quality of life using the Asthma Control Questionnaire and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) at baseline and after 3 months. A repeated measure analysis of variance was used to analyze the mean score difference between the two groups. @*Results@#There was no significant difference in mean score for asthma control at baseline between groups (F[degree of freedom (df)]=1.17 [1, 119], P=0.282). However, at 3 months, a significant difference in mean scores between groups was observed (F[df]=7.32 [1, 119], P=0.008). The mean±standard deviation (SD) scores in the intervention and control groups were 0.96±0.53 and 1.21±0.49, respectively. For the analysis of the PAQLQ, no significant difference was observed in the mean score for the quality of life baseline in both groups. There were significant mean score changes for the quality of life (F[df]=10.9 [1, 119], P=0.001) at 3 months follow-up, where those in the intervention group scored a mean±SD score of 6.19±0.45, and those in the control group scored 5.94±0.38. A time-group interaction analysis using repeated-measures analysis of variance showed significant differences in mean score changes (F[df]=5.03 [1, 116], P=0.027) and (F[df]=11.55 [1, 116], P=0.001) where a lower mean score was observed in the intervention group, indicating better asthma control and quality of life, respectively. A significant (P<0.001) negative Pearson correlation between asthma control and quality of life (-0.65) indicated a moderate correlation. @*Conclusion@#WAAP, along with standard asthma treatment, improves asthma care.
ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has affected several countries worldwide, including Malaysia, with the first reported case occurring in January 2020. Terengganu, a state on the east coast of Malaysia, is finding it challenging to contain the disease by aggressively instituting all public health measures to reduce the number of COVID-19 cases and community transmission. Our primary health clinic, which is situated in a semi-rural district in Terengganu, is also involved in the implementation of containment measures, community risk measurement, and the initial management of COVID-19 cases. The health clinic changed the clinic system for the delivery of healthcare services to avoid overcrowding of patients and adapted innovative ways of providing medical services, such as telemedicine and “drive-through” pharmacy. It also provided continuous health education and awareness regarding COVID-19 to both patients and clinic attendees. The essential element of combating the infection is the effective control of infection in a small, isolated clinic in which space and adequate facilities are known challenges. This study aimed to highlight the flow of COVID-19 management starting from screening, triaging, and management based on protocol, implementation of infection control measures, and training of healthcare workers in our health clinic. The mental health of these workers was managed by the Mental Health and Psychosocial Support Unit, as recommended by the Ministry of Health Malaysia. The role of primary care clinics in the ongoing pandemic is currently increasing. Hence, higher authority and the government must increase the number of facilities, human resources, and financial budget to ensure that all initiatives can be implemented effectively.