Effectiveness of peak flow meter in management of childhood asthma

Abstract

Objective : To assess the effectiveness of routine use of peak flow meter (PFM) in addition to symptom-based guided self-management of children with asthma.

Materials and Method : A prospective randomized controlled trial was performed in patients aged 6 - 15 years with persistent asthma who had been treated with inhaled corticosteroid (ICS) for at least 1 month. The recruited patients were randomized into 2 groups. The first group used PFM in addition to the symptoms assessment in self-management plan (PFM group) while the other group used only symptoms-based management plan (non-PFM group). All patients were evaluated in terms of symptom scores, quality of life scores and pulmonary function test at the beginning, during the 1^st or 2nd month and at the end of the 3^rd month.

Result : Sixty-six patients were studied (male: female 38: 28; mean age 8.9 ± 2.0 years); 87.8% and 12.2% of them had mild and moderate persistent asthma respectively. The average duration of ICS was 3.1 ± 2.1 years. There were no significant differences between the PFM group and the non-PFM group in terms of symptom scores [at 3^rd month 0.3 (0 - 4.1) vs. 0.3 (0 - 7); p >0.05], quality of life scores [6 ± 0.7 vs. 6.1 ± 0.8; p >0.05] and pulmonary function. However, the quality of life scores of the PFM group were significantly improved at the end of the 3rd month [5.7 ± 0.9 vs. 6.2 ± 0.7 (p = 0.003)].

Conclusion : The addition to routine PEFR monitoring to symptom-based guided self management did not result in significant differences from symptom-based guided self management alone in terms of symptom scores, quality of life scores and pulmonary function among children with mild to moderate persistent asthma. However, PFM may be beneficial in those who have been using ICS for 1 -3 years.