Peak expiratory flow rate: Difference between revisions

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==Effectiveness if monitoring patients with obstructive airways disease==
==Effectiveness if monitoring patients with obstructive airways disease==
In [[randomized controlled trial]]s of adult patients, use of the PEFR did not improve upon instructing patients in how to monitor the symptoms of their lung disease.<ref name="pmid9476870">{{cite journal |author=Turner MO, Taylor D, Bennett R, Fitzgerald JM |title=A randomized trial comparing peak expiratory flow and symptom self-management plans for patients with asthma attending a primary care clinic |journal=Am. J. Respir. Crit. Care Med. |volume=157 |issue=2 |pages=540–6 |year=1998 |pmid=9476870 |doi= |issn=}}</ref><ref name="pmid16931634">{{cite journal |author=Buist AS, Vollmer WM, Wilson SR, Frazier EA, Hayward AD |title=A randomized clinical trial of peak flow versus symptom monitoring in older adults with asthma |journal=Am. J. Respir. Crit. Care Med. |volume=174 |issue=10 |pages=1077–87 |year=2006 |pmid=16931634 |doi=10.1164/rccm.200510-1606OC |issn=}}</ref>
In [[randomized controlled trial]]s of adult patients, the role of the PEFR compared to instructing patients in how to monitor the symptoms of their lung disease is not clear with some studies reporting benefit<ref name="pmid12350190">{{cite journal |author=Weinberger M, Murray MD, Marrero DG, ''et al'' |title=Effectiveness of pharmacist care for patients with reactive airways disease: a randomized controlled trial |journal=JAMA |volume=288 |issue=13 |pages=1594–602 |year=2002 |pmid=12350190 |doi=}}</ref><ref name="pmid7661491">{{cite journal |author=Gibson PG, Wlodarczyk J, Hensley MJ, Murree-Allen K, Olson LG, Saltos N |title=Using quality-control analysis of peak expiratory flow recordings to guide therapy for asthma |journal=Ann. Intern. Med. |volume=123 |issue=7 |pages=488–92 |year=1995 |pmid=7661491 |doi=}}</ref><ref name="pmid9404750">{{cite journal |author=Cowie RL, Revitt SG, Underwood MF, Field SK |title=The effect of a peak flow-based action plan in the prevention of exacerbations of asthma |journal=Chest |volume=112 |issue=6 |pages=1534–8 |year=1997 |pmid=9404750 |doi=}}</ref> and others not finding benefit<ref name="pmid9476870">{{cite journal |author=Turner MO, Taylor D, Bennett R, Fitzgerald JM |title=A randomized trial comparing peak expiratory flow and symptom self-management plans for patients with asthma attending a primary care clinic |journal=Am. J. Respir. Crit. Care Med. |volume=157 |issue=2 |pages=540–6 |year=1998 |pmid=9476870 |doi= |issn=}}</ref><ref name="pmid16931634">{{cite journal |author=Buist AS, Vollmer WM, Wilson SR, Frazier EA, Hayward AD |title=A randomized clinical trial of peak flow versus symptom monitoring in older adults with asthma |journal=Am. J. Respir. Crit. Care Med. |volume=174 |issue=10 |pages=1077–87 |year=2006 |pmid=16931634 |doi=10.1164/rccm.200510-1606OC |issn=}}</ref><ref name="pmid11844120">{{cite journal |author=Adams RJ, Boath K, Homan S, Campbell DA, Ruffin RE |title=A randomized trial of peak-flow and symptom-based action plans in adults with moderate-to-severe asthma |journal=Respirology |volume=6 |issue=4 |pages=297–304 |year=2001 |pmid=11844120 |doi=}}</ref>. The specific advice given to the patient based on their PEFR may be important.<ref name="pmid7661491">{{cite journal |author=Gibson PG, Wlodarczyk J, Hensley MJ, Murree-Allen K, Olson LG, Saltos N |title=Using quality-control analysis of peak expiratory flow recordings to guide therapy for asthma |journal=Ann. Intern. Med. |volume=123 |issue=7 |pages=488–92 |year=1995 |pmid=7661491 |doi=}}</ref> According to a [[meta-analysis]] of [[randomized controlled trial]]s by the [[Cochrane Collaboration]], peak flow monitoring is equivalent to symptom monitoring.<ref name="pmid12535511">{{cite journal |author=Powell H, Gibson PG |title=Options for self-management education for adults with asthma |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD004107 |year=2003 |pmid=12535511 |doi=}}</ref>


Among children, some children seem to benefit from PEFR monitoring.<ref name="pmid17454329">{{cite journal |author=Burkhart PV, Rayens MK, Revelette WR, Ohlmann A |title=Improved health outcomes with peak flow monitoring for children with asthma |journal=J Asthma |volume=44 |issue=2 |pages=137–42 |year=2007 |pmid=17454329 |doi=10.1080/02770900601182517}}</ref><ref name="pmid11926622">{{cite journal |author=Yoos HL, Kitzman H, McMullen A, Henderson C, Sidora K |title=Symptom monitoring in childhood asthma: a randomized clinical trial comparing peak expiratory flow rate with symptom monitoring |journal=Ann. Allergy Asthma Immunol. |volume=88 |issue=3 |pages=283–91 |year=2002 |pmid=11926622 |doi=}}</ref>
Among children, some children seem to benefit from PEFR monitoring.<ref name="pmid17454329">{{cite journal |author=Burkhart PV, Rayens MK, Revelette WR, Ohlmann A |title=Improved health outcomes with peak flow monitoring for children with asthma |journal=J Asthma |volume=44 |issue=2 |pages=137–42 |year=2007 |pmid=17454329 |doi=10.1080/02770900601182517}}</ref><ref name="pmid11926622">{{cite journal |author=Yoos HL, Kitzman H, McMullen A, Henderson C, Sidora K |title=Symptom monitoring in childhood asthma: a randomized clinical trial comparing peak expiratory flow rate with symptom monitoring |journal=Ann. Allergy Asthma Immunol. |volume=88 |issue=3 |pages=283–91 |year=2002 |pmid=11926622 |doi=}}</ref>

Revision as of 23:50, 23 January 2008

The peak expiratory flow rate is the "measurement of the maximum rate of airflow attained during a forced vital capacity determination. Common abbreviations are PEFR and PFR."[1]

Effectiveness if monitoring patients with obstructive airways disease

In randomized controlled trials of adult patients, the role of the PEFR compared to instructing patients in how to monitor the symptoms of their lung disease is not clear with some studies reporting benefit[2][3][4] and others not finding benefit[5][6][7]. The specific advice given to the patient based on their PEFR may be important.[3] According to a meta-analysis of randomized controlled trials by the Cochrane Collaboration, peak flow monitoring is equivalent to symptom monitoring.[8]

Among children, some children seem to benefit from PEFR monitoring.[9][10]

References

  1. ↑ Anonymous. Peak expiratory flow rate. National Library of Medicine. Retrieved on 2008-01-23.
  2. ↑ Weinberger M, Murray MD, Marrero DG, et al (2002). "Effectiveness of pharmacist care for patients with reactive airways disease: a randomized controlled trial". JAMA 288 (13): 1594–602. PMID 12350190. [e]
  3. ↑ 3.0 3.1 Gibson PG, Wlodarczyk J, Hensley MJ, Murree-Allen K, Olson LG, Saltos N (1995). "Using quality-control analysis of peak expiratory flow recordings to guide therapy for asthma". Ann. Intern. Med. 123 (7): 488–92. PMID 7661491. [e]
  4. ↑ Cowie RL, Revitt SG, Underwood MF, Field SK (1997). "The effect of a peak flow-based action plan in the prevention of exacerbations of asthma". Chest 112 (6): 1534–8. PMID 9404750. [e]
  5. ↑ Turner MO, Taylor D, Bennett R, Fitzgerald JM (1998). "A randomized trial comparing peak expiratory flow and symptom self-management plans for patients with asthma attending a primary care clinic". Am. J. Respir. Crit. Care Med. 157 (2): 540–6. PMID 9476870. [e]
  6. ↑ Buist AS, Vollmer WM, Wilson SR, Frazier EA, Hayward AD (2006). "A randomized clinical trial of peak flow versus symptom monitoring in older adults with asthma". Am. J. Respir. Crit. Care Med. 174 (10): 1077–87. DOI:10.1164/rccm.200510-1606OC. PMID 16931634. Research Blogging.
  7. ↑ Adams RJ, Boath K, Homan S, Campbell DA, Ruffin RE (2001). "A randomized trial of peak-flow and symptom-based action plans in adults with moderate-to-severe asthma". Respirology 6 (4): 297–304. PMID 11844120. [e]
  8. ↑ Powell H, Gibson PG (2003). "Options for self-management education for adults with asthma". Cochrane Database Syst Rev (1): CD004107. PMID 12535511. [e]
  9. ↑ Burkhart PV, Rayens MK, Revelette WR, Ohlmann A (2007). "Improved health outcomes with peak flow monitoring for children with asthma". J Asthma 44 (2): 137–42. DOI:10.1080/02770900601182517. PMID 17454329. Research Blogging.
  10. ↑ Yoos HL, Kitzman H, McMullen A, Henderson C, Sidora K (2002). "Symptom monitoring in childhood asthma: a randomized clinical trial comparing peak expiratory flow rate with symptom monitoring". Ann. Allergy Asthma Immunol. 88 (3): 283–91. PMID 11926622. [e]

See also

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