Zoned Action Asthma Plan (ZAAP)

The Innovation

A patient self management tool designed to help patients manage their long term condition more effectively.

The Zoned Asthma Action Plan is a simple, credit-card sized, self-management plan that was designed by a local GP based in Kettering. The card has been successfully used within the practice for a number of years and is also routinely used at Grantham Hospital in Lincolnshire.



The ZAAP card is divided into four coloured zones; green, yellow, orange and red. Users match their current symptoms and peak flow to a zone and the card indicates the appropriate action. In a routine medical review consultation with a clinician, the card can be customised with the user’s own expected or best peak flow value. The card allows the patient to take manage their symptoms appropriately, refers them, if necessary to the appropriate practitioner (e.g. nurse, G.P, A & E) depending on the severity of their symptoms, thus reducing unnecessary

The Issues

The process of examining patients and their care is a continuum from a nurse simply asking how they feel in the morning and making a note of it all the way to the use of novel drugs and procedures on the same patients. This makes the distinction a difficult one to make and also raises the fundamental question of whether audit is any different from research and whether it should be considered a special case at all. After all audit usually would have a question to answer and will require intervention in patients notes or perhaps in canvassing their opinions as to how they felt their care had gone? How does that differ from research?

The Benefits

• Significantly increase the percentage of patients with asthma who carry a self-management Asthma Action Plan, using a co-ordinated, unified, multi-professional approach across a whole health community
• Evaluate the impact of the Asthma Action Plan, in terms of symptom control, service utilisation, quality of life, and patient satisfaction.

For further information contact:
Email: james.findlay@doctors.org.uk