The effect of a peak flow-based action plan in the prevention of exacerbations of asthma

Chest. 1997 Dec;112(6):1534-8. doi: 10.1378/chest.112.6.1534.


Study objective: To determine the effect of a symptom-based and a peak flow-based action plan in preventing acute exacerbations in subjects with poorly controlled asthma.

Design: A randomized controlled trial in which subjects who had required urgent treatment for their asthma were allocated to receive no action plan, a symptom-based plan, or a peak flow-based action plan.

Setting: A university hospital asthma clinic.

Population: One hundred fifty subjects were recruited after attending an emergency department or a clinic for urgent treatment of asthma.

Interventions: All subjects received evaluation and education for asthma before being randomly allocated to receive no action plan, a symptom-based action plan, or a peak flowmeter and a peak flow-based action plan.

Measurements: Subjects were assessed by questionnaire at 3 and 6 months after enrollment with questions relating to their asthma control and their need for urgent treatment or hospital admission for asthma.

Results: At 6 months after enrollment, although all three intervention groups experienced improvement in their asthma control, there was a striking reduction in emergency department visits for asthma only in the peak flow-based action plan group (p=0.006). No significant difference in emergency visits was apparent between the symptom-based action plan and no action plan groups.

Conclusions: We conclude that a peak flow-based action plan is effective, at least in the short term, in protecting patients with asthma against severe exacerbations of their disease.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Asthma / complications
  • Asthma / drug therapy
  • Asthma / physiopathology
  • Asthma / prevention & control*
  • Chi-Square Distribution
  • Emergencies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Patient Education as Topic
  • Peak Expiratory Flow Rate*
  • Risk Factors
  • Statistics, Nonparametric
  • Time Factors