Peak flow meters in childhood asthma: parent report of use and perceived usefulness.

INTRODUCTION

Peak flow meters (PFMs) in children with moderate to severe asthma have been used to monitor changes in asthma status and inform treatment decisions. However, their usefulness and the likelihood of their long-term use by families remains controversial.

METHODS

One hundred sixty-eight children ages 6 to 19 years were enrolled in a longitudinal randomized clinical trial to evaluate the impact of 3 different intensities of symptom monitoring on diverse clinical outcomes: subjective symptom monitoring, symptom-time PFM monitoring, and daily PFM monitoring.

RESULTS

At 3 months after the intervention, 90% of parents and 82% of children surveyed perceived a benefit to the monitoring method taught, regardless of group assignment. Ninety-three percent of parents but only 71% of children planned to continue that method. At 1 year after exiting from the study, 69% continued to use a PFM; 30% had discontinued use. No group differences existed in frequency of PFM use between symptom-time and daily users (x = 4.36 vs x = 4.31 times per month). Predictors of continued PFM use included greater frequency of symptoms and younger age. Those discontinuing use believed that it added no additional information to assist in management, using it was a chore/burden, it was not available when needed, and the child's asthma had improved.

DISCUSSION

Families will probably use a PFM to inform management during symptomatic times. Daily use is not perceived as useful by most families and is likely to be an unrealistic expectation for most children. J Pediatr Health Care.