Peak expiratory flow rate does not predict asthma exacerbations
The Journal of Family Practice. 2004 August;53(8):604-612
August 1, 2004|The Journal of Family Practice
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- CLINICAL QUESTION: Does measuring peak expiratory flow rate predict asthma exacerbations?
- STUDY DESIGN: Nonrandomized controlled trial
- SETTING: Outpatient (any)
- SYNOPSIS: This study was conducted in an interesting setting: 36 pharmacies spread over a wide geographic area were enrolled to study the effect of care provided by pharmacists to patients with asthma. Randomized by pharmacy, patients received either a peak flow meter with instructions from the pharmacist on how to use it, a peak flow meter with written instructions, or usual care (no peak flow monitor given). The 660 patients were evaluated at enrollment and at 6 and 12 months using the McMaster Asthma-Specific Quality of Life Questionnaire and measured peak expiratory flow rate (PEFR). Patients also were telephoned monthly to obtain their PEFR measurement and information about any recent emergency department visits and hospitalizations.
BOTTOM LINE
Routine measurement of peak expiratory flow rate does not predict subsequent asthma exacerbations. Therefore, routine measuring of lung function in this way is not useful. A peak flow meter does have a role in asthma management, but spot-checking in the office, other than to evaluate technique, is not helpful. (LOE=1b)
