Peak flow meters in childhood asthma: parent report of use and perceived usefulness
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Published on: February 9, 2022
Ann H McMullen1, H Lorrie Yoos, Harriet Kitzman
1University of Rochester School of Nursing, Rochester, NY 14642, USA.
Insights
Most families find peak flow meters (PFMs) useful for managing asthma during symptomatic periods. However, daily PFM monitoring is often perceived as burdensome and unrealistic for children with asthma.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Clinical Trial Research
Background:
- Peak flow meters (PFMs) are utilized in managing moderate to severe pediatric asthma.
- The long-term utility and adherence of PFMs in children remain debated.
Purpose of the Study:
- To evaluate the impact of different symptom monitoring intensities on asthma outcomes.
- To assess the long-term use and perceived benefits of PFMs by children and families.
Main Methods:
- A longitudinal randomized clinical trial involving 168 children (ages 6-19).
- Three monitoring groups: subjective symptom monitoring, symptom-time PFM monitoring, and daily PFM monitoring.
- Outcomes assessed included perceived benefit, planned continuation, and actual long-term PFM use.
Main Results:
- High perceived benefit (90% parents, 82% children) at 3 months.
- High planned continuation by parents (93%) vs. children (71%).
- At 1 year, 69% continued PFM use; predictors included symptom frequency and younger age. Discontinuation reasons included perceived lack of added information and burden.
Conclusions:
- PFMs are likely to be used by families for symptom-based asthma management.
- Daily PFM monitoring is generally not perceived as useful and is an unrealistic expectation for most children.
- Symptom-time PFM monitoring appears more sustainable for pediatric asthma management.
Introduction:
Peak flow meters (PFMs) in children with moderate to severe asthma have been used to monitor changes in asthma status and inform treatment decisions. However, their usefulness and the likelihood of their long-term use by families remains controversial.
Methods:
One hundred sixty-eight children ages 6 to 19 years were enrolled in a longitudinal randomized clinical trial to evaluate the impact of 3 different intensities of symptom monitoring on diverse clinical outcomes: subjective symptom monitoring, symptom-time PFM monitoring, and daily PFM monitoring.
Results:
At 3 months after the intervention, 90% of parents and 82% of children surveyed perceived a benefit to the monitoring method taught, regardless of group assignment. Ninety-three percent of parents but only 71% of children planned to continue that method. At 1 year after exiting from the study, 69% continued to use a PFM; 30% had discontinued use. No group differences existed in frequency of PFM use between symptom-time and daily users (x = 4.36 vs x = 4.31 times per month). Predictors of continued PFM use included greater frequency of symptoms and younger age. Those discontinuing use believed that it added no additional information to assist in management, using it was a chore/burden, it was not available when needed, and the child's asthma had improved.
Discussion:
Families will probably use a PFM to inform management during symptomatic times. Daily use is not perceived as useful by most families and is likely to be an unrealistic expectation for most children. J Pediatr Health Care.
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