title: Prediction of peak flow values followed by feedback improves perception of lung function and adherence to inhaled corticosteroids in children with asthma.
abstract: BACKGROUND
  Failure to detect respiratory compromise can lead to emergency healthcare use and fatal asthma attacks. The purpose of this study was to examine the effect of predicting peak expiratory flow (PEF) and receiving feedback on perception of pulmonary function and adherence to inhaled corticosteroids (ICS).
  
  
  METHODS
  The sample consisted of 192 ethnic minority, inner-city children (100 Puerto Rican, 54 African-American, 38 Afro-Caribbean) with asthma and their primary caregivers recruited from outpatient clinics in Bronx, New York. Children's PEF predictions were entered into an electronic spirometer and compared with actual PEF across 6 weeks. Children in one study were blinded to PEF (n=88; no feedback) and children in a separate study were able to see PEF (n=104; feedback) after predictions were locked in. Dosers were attached to asthma medications to monitor use.
  
  
  RESULTS
  Children in the feedback condition displayed greater accuracy (p<0.001), less under-perception (p<0.001) and greater over-perception (p<0.001) of respiratory compromise than children in the no feedback condition. This between-group difference was evident soon after baseline training and maintained across 6 weeks. The feedback condition displayed greater adherence to ICS (p<0.01) and greater quick-relief medication use (p<0.01) than the no feedback condition.
  
  
  CONCLUSIONS
  Feedback on PEF predictions for ethnic minority, inner-city children may decrease under-perception of respiratory compromise and increase adherence to controller medications. Children and their families may shift their attention to asthma perception and management as a result of this intervention.
authors.affiliation: Ferkauf Graduate School of Psychology/Yeshiva University, Rousso Building, Bronx, NY 10461, USA. jonathan.feldman@einstein.yu.edu
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Feldman
authors.forename: Haley
authors.initials: H
authors.lastname: Kutner
authors.forename: Lynne
authors.initials: L
authors.lastname: Matte
authors.forename: Michelle
authors.initials: M
authors.lastname: Lupkin
authors.forename: Dara
authors.initials: D
authors.lastname: Steinberg
authors.forename: Kimberly
authors.initials: K
authors.lastname: Sidora-Arcoleo
authors.forename: Denise
authors.initials: D
authors.lastname: Serebrisky
authors.forename: Karen
authors.initials: K
authors.lastname: Warman
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000704:Analysis of Variance; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology; D002648:Child; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D009519:New York City; D010349:Patient Compliance; D010366:Peak Expiratory Flow Rate; D010465:Perception; D013147:Spirometry; D014505:Urban Population
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents