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Measuring peak flow enhances adherence to monitoring in asthma
  1. Cassandra A Slader1,
  2. Elena G Belousova2,
  3. Helen K Reddel2
  1. 1Co-operative Research Centre for Asthma, University of Sydney, and Faculty of Pharmacy, University of Sydney, Australia
  2. 2Co-operative Research Centre for Asthma, University of Sydney, and Woolcock Institute of Medical Research, Camperdown, Australia
  1. Correspondence to:
    Dr H K Reddel
    Woolcock Institute of Medical Research, PO Box M77 Camperdown, New South Wales, Australia 2050; hkr{at}

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Peak expiratory flow (PEF) monitoring is recommended in the management of moderate to severe asthma,1 and PEF outcome variables are used in many clinical trials. However, adherence with PEF monitoring is poor, and this is often attributed to the burden of measurement and recording. This analysis examined whether adherence with symptom monitoring was impaired by asking patients also to record PEF measurements.

Data were obtained from a randomised double blind study of breathing techniques in adults with poorly controlled asthma. Full details of the clinical trial are reported elsewhere.2 Subjects were non-smokers aged 19–80 years, using reliever as-needed ⩾4 times/week and taking inhaled corticosteroids ⩾200 μg/day. Figure 1 shows the study design, with between-visit intervals of 2 or 6 weeks. Throughout the study, 57 subjects used electronic diary spirometers (AM2, Erich Jaeger GmbH, Hoechberg, Germany) twice daily to answer questions about symptom frequency/intensity and treatment. There were three “PEF periods” during which subjects also measured spirometry twice daily. PEF was displayed after each of three manoeuvres followed by the highest PEF. …

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