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Addition of peak flow monitoring to symptom monitoring did not improve healthcare visits, quality of life, or lung function in older adults with moderate-to-severe asthma

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 Q In older adults with moderate-to-severe asthma, is symptom monitoring plus peak flow monitoring (PFM) (used as part of a comprehensive management plan) better than symptom monitoring alone for healthcare use, quality of life, and lung function?


Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded (data collectors and {healthcare providers}*).

Embedded ImageFollow up period:

up to 2 years.

Embedded ImageSetting:

a large managed care organisation in Oregon, USA.

Embedded ImagePatients:

296 adults 50–92 years of age (mean age 66 y, 52% women) who had physician diagnosed asthma, medication use suggestive of moderate-to-severe asthma, bronchodilator reversibility (>8% of baseline FEV1), and demonstrated ability to keep a daily symptom diary.

Embedded ImageIntervention:

symptom monitoring plus PFM (n = 149) or symptom monitoring only (n = 147). All patients attended four 90 minute small group sessions that included development of personalised action plans and review of asthma diaries. Patients were instructed in …

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  • * Information provided by author.

  • See glossary.

  • For correspondence: Dr A S Buist, Oregon Health and Science University, Portland, OR, USA. buists{at}

  • Source of funding: National Heart, Lung, and Blood Institute.

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