Self-Management Support

Asthma self-management support for people with severe asthma comprises two main components:

1. Educating and ‘working with’ your patient to help them build their skills, knowledge, strategies and behaviours. This is an approach that helps people to ‘live well’ with severe asthma. As a result of significant daily disease burden and complex management approaches, people with severe asthma often require support for their self-management strategies.
2. Enabling healthcare provider sources of support to the patient. People with limited family or social support, may be unaware of or unable to access additional external support. Patients often express concern for the burden they place on their support network. It is important to also consider the support provided to carers.

“When I got home I couldn’t do anything around the house…I don’t work at all anymore, because I am too sick now to work at all…..for years my son has done all of the grocery shopping….my life has become very reduced”
Video provided by Professor Lorraine Smith and Dr. Daniela Eassey, University of Sydney.

There are numerous models of self-management support for long-term conditions, such as the Australian Flinders Program, and the Stanford Self-Management Program.

The desirable self-management characteristics of a person with a long-term condition such as severe asthma includes:

• Knowledge of the condition and knowledge of treatment options
• Good working relationship with healthcare providers
• Knowing when to seek expert help when there is an exacerbation
• Problem solving skills
• Able to set realistic and achievable goals, and develop strategies to achieve goals
• Emotional self-regulation (a commonly neglected aspect of healthcare provision).
• Participation in daily activities that are meaningful to the individual
• Strong and positive social support network
• Able to recognise increase/change in asthma symptoms.

“I would like to do voluntary work….I would like to continue my rehab and get well…there are lots of things I would like to do and goals that I have….I can’t do them because I can’t breathe”
Video provided by Professor Lorraine Smith and Dr. Daniela Eassey, University of Sydney.

• Limited access to specialist care
• Limited public transport options and requirement for travel
• Reimbursements available for travel expenses
• Consider logistics for referrals, appointment scheduling, access to diagnostic tests
• Consider access to specialist medications

It is important for healthcare providers to recognise that patients with severe asthma, like most individuals, have life goals and that severe asthma is one aspect of their life. Many people with severe asthma will strive to integrate severe asthma into their life, so that it doesn’t dominate who they are or what they do. However, this is often challenging for those with severe asthma. Severe asthma can also pose a threat to personal autonomy and identity. In a qualitative study by Eassey et al, two important themes were highlighted as factors in sustaining autonomy and identity for people living with severe asthma – these were a desire to live an ‘unconstrained life’ and the importance of ‘self-identity’ (Eassey et al. 2021 & Eassey et al. 2019). Allowing space for people to feel empowered, having choices in their decision making, having input into treatment options and knowing about medications and their side‐effects are all ways health care professionals can uphold autonomy and identity for patients (Eassey et al. 2019).