The effect of a peak flow-based action plan in the prevention of exacerbations of asthma.
OBJECTIVE
To determine the effect of a symptom-based and a peak flow-based action plan in preventing acute exacerbations in subjects with poorly controlled asthma.


METHODS
A randomized controlled trial in which subjects who had required urgent treatment for their asthma were allocated to receive no action plan, a symptom-based plan, or a peak flow-based action plan.


METHODS
A university hospital asthma clinic.


METHODS
One hundred fifty subjects were recruited after attending an emergency department or a clinic for urgent treatment of asthma.


METHODS
All subjects received evaluation and education for asthma before being randomly allocated to receive no action plan, a symptom-based action plan, or a peak flowmeter and a peak flow-based action plan.


METHODS
Subjects were assessed by questionnaire at 3 and 6 months after enrollment with questions relating to their asthma control and their need for urgent treatment or hospital admission for asthma.


RESULTS
At 6 months after enrollment, although all three intervention groups experienced improvement in their asthma control, there was a striking reduction in emergency department visits for asthma only in the peak flow-based action plan group (p=0.006). No significant difference in emergency visits was apparent between the symptom-based action plan and no action plan groups.


CONCLUSIONS
We conclude that a peak flow-based action plan is effective, at least in the short term, in protecting patients with asthma against severe exacerbations of their disease.
Cowie
R L
RL
Calgary Asthma Program, University of Calgary, Alberta, Canada.
Revitt
S G
SG
Underwood
M F
MF
Field
S K
SK
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D016009:Chi-Square Distribution; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D010366:Peak Expiratory Flow Rate; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013997:Time Factors