title: Spirometry and regular follow-up do not improve quality of life in children or adolescents with asthma: Cluster randomized controlled trials.
abstract: BACKGROUND
  To determine whether spirometry and regular medical review improved quality of life or other outcomes in children and adolescents with asthma.
  
  
  METHODS
  We conducted two cluster randomized controlled trials. We recruited 238 asthma patients aged between 7 and 17 years from 56 general practices in South Eastern Australia. Participants were randomized to receive an intervention that included spirometry or usual care. The main outcome measure was asthma related quality of life.
  
  
  RESULTS
  Baseline characteristics were well matched between the intervention and control groups. Neither trial found any difference in asthma related quality of life between groups. However because of measurement properties, a formal meta-analysis could not be performed. Nor were there any significant effects of the intervention upon asthma attacks, limitation to usual activities, nocturnal cough, bother during physical activity, worry about asthma, or written asthma action plans.
  
  
  CONCLUSIONS
  The findings do not support more widespread use of spirometry for the management of childhood asthma in general practice, unless it is integrated into a complete management model.
authors.affiliation: Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Vic, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Abramson
authors.affiliation: Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Vic, Australia.
authors.forename: Rosa L
authors.initials: RL
authors.lastname: Schattner
authors.affiliation: Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Holton
authors.affiliation: Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Vic, Australia.
authors.forename: Pam
authors.initials: P
authors.lastname: Simpson
authors.affiliation: Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Nancy
authors.initials: N
authors.lastname: Briggs
authors.affiliation: Faculty of Health Sciences, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Justin
authors.initials: J
authors.lastname: Beilby
authors.affiliation: Menzies Research Institute Tasmania, Hobart, Tas, Australia.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Nelson
authors.affiliation: Menzies Research Institute Tasmania, Hobart, Tas, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Wood-Baker
authors.affiliation: Department of Respiratory Medicine, Eastern Health & Monash University, Box Hill, Vic, Australia.
authors.forename: Francis
authors.initials: F
authors.lastname: Thien
authors.affiliation: Department of Family & Community Medicine, University of Sharjah, Sharjah, UAE.
authors.forename: Nabil D
authors.initials: ND
authors.lastname: Sulaiman
authors.affiliation: Pulmetrics Pty Ltd, East Doncaster, Vic, Australia.
authors.forename: Eleonora Del
authors.initials: ED
authors.lastname: Colle
authors.affiliation: Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Vic, Australia.
authors.forename: Rory
authors.initials: R
authors.lastname: Wolfe
authors.affiliation: Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Crockett
authors.affiliation: Department of Respiratory Medicine, Royal Children's Hospital, Melbourne, Vic, Australia.
authors.forename: R John
authors.initials: RJ
authors.lastname: Massie
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D001315:Australia; D002648:Child; D003266:Continuity of Patient Care; D019468:Disease Management; D005260:Female; D005541:Forced Expiratory Volume; D058006:General Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D011788:Quality of Life; D013147:Spirometry
keywords: adolescent; asthma; child; family practice; randomized controlled trials; spirometry