title: The effect of a peak flow-based action plan in the prevention of exacerbations of asthma.
abstract: 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.
authors.affiliation: Calgary Asthma Program, University of Calgary, Alberta, Canada.
authors.forename: R L
authors.initials: RL
authors.lastname: Cowie
authors.forename: S G
authors.initials: SG
authors.lastname: Revitt
authors.forename: M F
authors.initials: MF
authors.lastname: Underwood
authors.forename: S K
authors.initials: SK
authors.lastname: Field
mesh_terms: 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