New approach to peak flow monitoring

When it comes to asthma monitoring, the eye is the key; according to Associate Professor Helen Reddel, who has spent years researching and refining a new peak expiratory flow chart.

The new chart, which is now available for free from the National Asthma Council Australia and Woolcock Institute of Medical Research websites, has been designed to enable easy identification of changes in lung function and to overcome the confusion caused by the disparity of charts in circulation.

“Being able to interpret the results at a glance is critical,” explained Assoc Prof Reddel, Research Leader at the Woolcock and Respiratory Physician at the Asthma Centre at Royal Prince Alfred Hospital.

“But, unfortunately there are so many different charts available in Australia for recording peak flow, that this has not previously been possible.

“The design of some existing charts actually makes changes in lung function extremely hard to detect and can hide important variations in asthma control,” she cautioned.

Research has shown that the shape of the chart itself has an effect on our perception of the results.

“On a stretched-out chart, even a severe exacerbation may appear mild and the beginning of the exacerbation may be hard to recognise,” Assoc Prof Reddel said. “On a chart that is compressed horizontally, however, it is easy for the patient or doctor to see when the peak flow falls below the patient's usual range and to see gradual rises or falls in peak flow.”

Based on her research and feedback from patients and health professionals who have piloted the new chart, Assoc Prof Reddel is a strong advocate for the standardisation of PEF charts in Australia.

“There should be no room for confusion,” she said. “In the same way that ECG traces are displayed consistently in every ICU around the country, peak flow readings should be displayed consistently too.

“Immediate, consistent, visual impact is the key to ensuring peak flow monitoring is an effective asthma management tool when it is used.”

The National Asthma Council's Asthma Management Handbook 2006 recommends peak flow monitoring for certain adults with moderate to severe asthma, in addition to monitoring of asthma symptoms and reliever use.

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