- Meta-analysis included all randomized controlled trials in children of (a) written action plan vs no plan, or (b) comparison of different types of written plans.
- Only one RCT compared a written plan with no written plan for children with moderate persistent asthma so meta-analysis was not possible. In these children, who all received a moderate dose daily inhaled steroid and asthma education, with a written plan there was a decrease in acute asthma events (0.5 vs 1.0 events per subject), school days missed (1.5 vs 2.5 days per subject), and symptom score (21.9 vs 33.7) over the study period of 3 months.
- Meta-analysis of 4 RCTs comparing symptom-based and peak flow-based written action plans showed a 27% decrease in acute care visits for asthma exacerbation with symptom-based plans (RR=0.73, 95% CI 0.55 to 0.99, NNT=8).
- Meta-analysis of the 4 RCTs above showed no difference in secondary endpoints including need for oral steroids or hospital admission, or school absenteeism.