PMID- 11493372 OWN - NLM STAT- MEDLINE DCOM- 20011204 LR - 20191025 IS - 0269-4727 (Print) IS - 0269-4727 (Linking) VI - 26 IP - 4 DP - 2001 Aug TI - Peak expiratory flow rate and symptom self-monitoring of asthma initiated from community pharmacies. PG - 287-96 AB - OBJECTIVE: To compare the use of patient-performed peak expiratory flow (PEFR) and symptom monitoring as asthma self-management tools initiated from community pharmacies. DESIGN AND SETTING: 110 patients over 6 years of age were recruited from five private-sector community pharmacies. Patients were identified from pharmacist recall as having 'asthma'. Information on the frequency of their asthma symptoms, medication use, level of physical activity, school or work attendance and lung function was obtained using a questionnaire to classify patients as either mild, moderate or severe. Each patient was alternately assigned to either the symptom or PEFR monitoring procedure in the order they were recruited. Patients performing symptom monitoring used a visual analogue scale to assess symptoms, whereas those in the PEFR monitoring group assessed symptoms and used a pocket-size peak flow meter to measure lung function. Both self-monitoring groups were required to adhere to an individualized management plan based on guideline recommendations and to record their monitored data in a diary card for 2 months. Data from the diary cards were reviewed, collated, transcribed and analysed using the Student t and Mann-Whitney tests. OUTCOME MEASURES: The average monthly frequency of appropriate patient responses determined from their adherence to the self-management plan was used to compare the usefulness of symptom and PEFR self-monitoring. In particular, appropriate use of medication and need for medical consultation was compared. RESULTS: 21 symptom and 40 PEFR-assigned patients completed 2 months' monitoring. The average monthly frequency of appropriate responses in patients using PEFR (0.76) was significantly higher than that of patients using symptom monitoring (0.53, P < 0.006). Patients applying symptom monitoring had a higher monthly frequency (0.39) of inappropriate medication use compared to the PEFR group (0.14). Furthermore, the patients' mean daily symptom scores (2.85) were significantly lower than that estimated by the researcher (4.12, P < 0.03). For all three asthma severity groups a higher monthly average of appropriate responses was observed in patients using PEFR monitoring compared to those who used symptom monitoring. CONCLUSION: PEFR self-monitoring proved to be a more useful asthma tool than symptom self-monitoring. Patients applying symptom monitoring tend to underestimate the severity of their condition and use medication inappropriately. Active involvement of community pharmacists in facilitating and reinforcing out-patient self-monitoring would help to optimize asthma management. FAU - Bheekie, A AU - Bheekie A AD - Department of Pharmacology, School of Pharmacy, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa. abheekie@uwc.ac.za FAU - Syce, J A AU - Syce JA FAU - Weinberg, E G AU - Weinberg EG LA - eng PT - Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - J Clin Pharm Ther JT - Journal of clinical pharmacy and therapeutics JID - 8704308 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Asthma/diagnosis/*pathology MH - Child MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Patient Education as Topic MH - Peak Expiratory Flow Rate MH - Pharmacies MH - Reproducibility of Results MH - *Self Care MH - Sensitivity and Specificity MH - Severity of Illness Index EDAT- 2001/08/09 10:00 MHDA- 2002/01/05 10:01 CRDT- 2001/08/09 10:00 PHST- 2001/08/09 10:00 [pubmed] PHST- 2002/01/05 10:01 [medline] PHST- 2001/08/09 10:00 [entrez] AID - jcp361 [pii] AID - 10.1046/j.1365-2710.2001.00361.x [doi] PST - ppublish SO - J Clin Pharm Ther. 2001 Aug;26(4):287-96. doi: 10.1046/j.1365-2710.2001.00361.x.