Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Dr. Laura Kuensting


Dr. Louise Miller


Dr. Carla Moore Beckerle


Background: Chronic lower respiratory disease, including asthma, is the fourth leading cause of death in the U.S. Financially, asthma accounts for approximately 54 billion dollars in healthcare spending annually. The National Heart Lung and Blood Institute [NHLBI] established guidelines to reduce impairment and to reduce future asthma attacks.

Purpose: This Quality Improvement (QI) pilot implemented the Asthma Control Test (ACT) and the Asthma Action Plan (AAP) per NHLBI guidelines. This project aimed to increase provider use of the ACT and AAP to 50% in patients with a diagnosis of asthma over one month.

Methods: A convenience sample of six adult patients ages 18-64 years with a diagnosis of asthma from a primary care office in a large suburban county in the Midwest were included. During a scheduled office visit, participants completed the ACT. Based on the ACT score, the provider customized an AAP for at-home use. The patient was contacted two weeks following the office visit to reassess the ACT score.

Results: Use of the ACT and AAP by providers increased to 75%. The mean ACT baseline score was 15.3 indicative of asthma not well controlled. Follow-up ACT score mean was 19 indicating well-controlled asthma.

Implications: The National Heart Lung Blood Institute recommends an annual assessment of asthma control with the Asthma Control Test and an individualized Asthma Action Plan. This project suggests clinical benefit for improving control of asthma symptoms. Further evaluation is required.