[Peak expiratory flow (PEF)].

Area of Science:

• Pulmonology and Respiratory Medicine
• Clinical Medicine

Context:

• Asthma management involves controller and reliever medications, with decisions often based on symptom perception or peak expiratory flow (PEF).
• Patient self-assessment of asthma severity can be unreliable, potentially leading to delayed or inadequate treatment.
• There is ongoing debate regarding the utility and effectiveness of peak flow monitoring (PFM) in clinical practice.

Purpose:

• To review and synthesize current evidence on the significance of peak expiratory flow (PEF) and peak flow monitoring (PFM) in the management of adult asthma.
• To evaluate the role of objective measurements versus subjective symptom perception in guiding asthma treatment decisions.
• To highlight the potential risks associated with the underestimation of airway obstruction by patients.

Summary:

• Asthma patients frequently underestimate symptom severity and airway obstruction, increasing their risk of severe exacerbations and mortality.
• Peak flow monitoring (PFM) offers an objective measure of airflow, potentially improving the accuracy of asthma assessment.
• The review examines the controversial role of PEF and PFM in adult asthma management, contrasting their benefits against patient-reported outcomes.

Impact:

• Highlights the importance of objective asthma monitoring tools like PFM to prevent severe outcomes.
• Informs clinical guidelines and patient education on the benefits of regular peak flow measurement.
• Emphasizes the need for healthcare providers to consider objective data alongside patient perception for optimal asthma control.