Chulalongkorn Medical Journal


Objective : To assess the effectiveness of routine use of peak flow meter(PFM) in addition to symptom-based guided self-managementof children with asthma.Materials and Method : A prospective randomized controlled trial was performed inpatients aged 6 - 15 years with persistent asthma who had beentreated with inhaled corticosteroid (ICS) for at least 1 month.The recruited patients were randomized into 2 groups. The firstgroup used PFM in addition to the symptoms assessment inself-management plan (PFM group) while the other group usedonly symptoms-based management plan (non-PFM group). Allpatients were evaluated in terms of symptom scores, quality oflife scores and pulmonary function test at the beginning, duringthe 1st or 2nd month and at the end of the 3rd month.Result : Sixty-six patients were studied (male: female 38: 28; meanage 8.9 ± 2.0 years); 87.8% and 12.2% of them had mild andmoderate persistent asthma respectively. The average durationof ICS was 3.1 ± 2.1 years. There were no significant differencesbetween the PFM group and the non-PFM group in terms ofsymptom scores [at 3rd month 0.3 (0 - 4.1) vs. 0.3 (0 - 7);p >0.05], quality of life scores [6 ± 0.7 vs. 6.1 ± 0.8; p >0.05]and pulmonary function. However, the quality of life scores ofthe PFM group were significantly improved at the end of the 3rdmonth [5.7 ± 0.9 vs. 6.2 ± 0.7 (p = 0.003)].Conclusion : The addition to routine PEFR monitoring to symptom-basedguided self management did not result in significant differencesfrom symptom-based guided self management alone in termsof symptom scores, quality of life scores and pulmonary functionamong children with mild to moderate persistent asthma.However, PFM may be beneficial in those who have been usingICS for 1 -3 years.


Faculty of Medicine, Chulalongkorn University

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