STUDY OBJECTIVE: To determine the effect of a symptom-based and a peak flow-based action plan in preventing acute exacerbations in subjects with poorly controlled asthma. DESIGN: A randomized controlled trial in which subjects who had required urgent treatment for their asthma were allocated to receive no action plan, a symptom-based plan, or a peak flow-based action plan. SETTING:A university hospital asthma clinic. POPULATION: One hundred fifty subjects were recruited after attending an emergency department or a clinic for urgent treatment of asthma. INTERVENTIONS: All subjects received evaluation and education for asthma before being randomly allocated to receive no action plan, a symptom-based action plan, or a peak flowmeter and a peak flow-based action plan. MEASUREMENTS: Subjects were assessed by questionnaire at 3 and 6 months after enrollment with questions relating to their asthma control and their need for urgent treatment or hospital admission for asthma. RESULTS: At 6 months after enrollment, although all three intervention groups experienced improvement in their asthma control, there was a striking reduction in emergency department visits for asthma only in the peak flow-based action plan group (p=0.006). No significant difference in emergency visits was apparent between the symptom-based action plan and no action plan groups. CONCLUSIONS: We conclude that a peak flow-based action plan is effective, at least in the short term, in protecting patients with asthma against severe exacerbations of their disease.
RCT Entities:
STUDY OBJECTIVE: To determine the effect of a symptom-based and a peak flow-based action plan in preventing acute exacerbations in subjects with poorly controlled asthma. DESIGN: A randomized controlled trial in which subjects who had required urgent treatment for their asthma were allocated to receive no action plan, a symptom-based plan, or a peak flow-based action plan. SETTING: A university hospital asthma clinic. POPULATION: One hundred fifty subjects were recruited after attending an emergency department or a clinic for urgent treatment of asthma. INTERVENTIONS: All subjects received evaluation and education for asthma before being randomly allocated to receive no action plan, a symptom-based action plan, or a peak flowmeter and a peak flow-based action plan. MEASUREMENTS: Subjects were assessed by questionnaire at 3 and 6 months after enrollment with questions relating to their asthma control and their need for urgent treatment or hospital admission for asthma. RESULTS: At 6 months after enrollment, although all three intervention groups experienced improvement in their asthma control, there was a striking reduction in emergency department visits for asthma only in the peak flow-based action plan group (p=0.006). No significant difference in emergency visits was apparent between the symptom-based action plan and no action plan groups. CONCLUSIONS: We conclude that a peak flow-based action plan is effective, at least in the short term, in protecting patients with asthma against severe exacerbations of their disease.
Authors: A Sonia Buist; William M Vollmer; Sandra R Wilson; E Ann Frazier; Arthur D Hayward Journal: Am J Respir Crit Care Med Date: 2006-08-24 Impact factor: 21.405
Authors: Michelle Boyd; Toby J Lasserson; Michael C McKean; Peter G Gibson; Francine M Ducharme; Michelle Haby Journal: Cochrane Database Syst Rev Date: 2009-04-15
Authors: Rick Hodder; M Diane Lougheed; Brian H Rowe; J Mark FitzGerald; Alan G Kaplan; R Andrew McIvor Journal: CMAJ Date: 2009-10-26 Impact factor: 8.262