The role of PEF monitoring in detecting exacerbations

Monitoring of asthma control based on PEF may have the greatest benefit in patients who cannot readily perceive symptoms of airflow limitation.

Self-monitoring based on peak expiratory flow (PEF) might help some patients detect the onset of potentially severe exacerbations earlier, but there is no strong evidence that this offers any advantage over symptom monitoring for most patients.^4,5

• Those who cannot easily perceive worsening airflow limitation or confuse symptoms (e.g. elderly patients) may benefit most from PEF-based monitoring.

See Asthma in the elderly

• Before a 30% reduction in PEF from personal best is detected, most patients become aware of symptoms suggesting worsening asthma control (e.g. breathlessness, increased reliever usage) and either seek medical care or start additional treatment.^4,5,6
• Among patients using PEF-based asthma action plans to manage their asthma in response to fluctuations in symptom control, alterations in treatment should be based on deviation from personal best PEF, rather than comparison with predicted PEF.⁷
• In children, no clear benefit has been demonstrated for PEF-based asthma action plans over symptom-based action plans.^6,8,9

For information on self-management in response to changes in asthma control, see Asthma action plans.

Content Created (Thursday, 16 November 2006)