Peak Flow Meter and Spacer Use in Adolescents with Asthma: More than Just Ownership

Effective self-management is essential for optimizing asthma control. Although peak flow meters (PFMs) and spacers are recommended to support self-management, the associations between device use patterns and asthma outcomes remain unclear. This study aims to examine the ownership and use of devices among adolescents with asthma and their associations with asthma exacerbations in the past 12 months and asthma control.

Cross-sectional data from 373 inner-city adolescents with asthma were analyzed. Participants reported PFM or spacer ownership and their frequency of use. Exacerbation history was determined based on oral corticosteroid use, hospitalizations, and emergency department visits in the past 12 months. Asthma control was assessed using the Asthma Control Questionnaire. Chi-square tests and independent t-tests were used to examine associations among device ownership, use frequency, asthma control, and exacerbations.

Ownership rates were 36% for PFMs and 61.6% for spacers. Ownership of both devices was negatively associated with asthma exacerbations in the past year (all p < 0.001). Regular use was reported by only 15.2% of PFM owners and 40.2% of spacer owners. Regular users did not differ from infrequent users in exacerbation history but reported significantly poorer asthma control (PFM: p = 0.007; spacer: p < 0.001).

Adolescents' ownership of peak flow meters and spacers remains suboptimal, and the routine adoption of these devices is limited. Adolescents with exacerbations in the past year were more likely to own devices but use them infrequently. Regular use was associated with poorer asthma control, suggesting reactive rather than preventive use. Findings highlight the need for improved education on preventive device use, enhanced training in proper use, and proactive integration of devices into adolescent asthma self-management.