Education, self-management and home peak flow monitoring in childhood asthma.
Current asthma guidelines focus on self-management by the patient, in which monitoring of peak flow plays an important role. To be able to participate in self-management, the patient must be educated rigorously on pathophysiological mechanisms of the disease, principles of treatment, correct inhalation technique, treatment goals and the action to take when symptoms or peak flow worsen. This is a time-consuming but important and worthwhile task. The pivotal role of home peak flow monitoring in asthma self-management is based on the assumptions that peak flow variation is a useful measure of disease activity and that peak flow diaries are kept reliably by patients. There is now evidence that neither of these assumptions are true. Self-management plans based on education alone are just as effective as those incorporating peak flow monitoring. Education, therefore, is the most important component of asthma self-management, and home peak flow monitoring is not needed in the majority of asthmatic children.
Kamps
A W
AW
Department of Paediatrics, Division of Paediatric Pulmonology, Isala Klinieken, PO Box 10500, 8000 GM Zwolle, The Netherlands.
Brand
P L
PL
D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D010366:Peak Expiratory Flow Rate; D015203:Reproducibility of Results; D012307:Risk Factors; D012648:Self Care / Q000379:methods / Q000592:standards*; D012720:Severity of Illness Index; D013147:Spirometry