TY - JOUR
T1 - Peak flow measurements in children with asthma
T2 - What happens at school?
AU - Grad, Roni
AU - McClure, Leslie
AU - Zhang, Sijon
AU - Mangan, Joan
AU - Gibson, Linda
AU - Gerald, Lynn
N1 - Funding Information:
This study was funded by NHLBI 5 R01 HL075043; Blue Cross/Blue Shield of Alabama; Astra Zeneca Pharmaceuticals. *Corresponding author: Dr. Roni Grad, Pediatrics, University of Arizona, 1501 North Campbell Avenue, Tucson, AZ 85724-5073; E-mail: [email protected]
PY - 2009/8
Y1 - 2009/8
N2 - Background. Self-monitoring of symptoms or peak flow monitoring (PFM) is recommended for all asthma patients and is commonly included in asthma management plans. Limited data are available documenting PFM outcomes in school settings. Method. Three hundred twenty-three urban children with persistent asthma were enrolled in a school-based study that implemented an internet-based asthma monitoring and data collection system. The mean age of the children was 10.0 (SD 2.1) years; 57% were male and 91% were African American. Children logged in daily to an internet-based program to record their asthma symptoms and PFM reading. Teachers logged in daily to confirm the PFM readings. School staff responsible for student health reported actions taken for low PFM readings. Results. A total of 12,245 child reports were completed; 98% (n = 11,974) had corresponding teacher reports, confirming the peak flow meter readings reported by the children. The prevalence of reported asthma symptoms varied across PFM readings; the highest prevalence occurred in the setting of red zone readings, with intermediate prevalence in the setting of yellow zone readings, and lowest prevalence in the setting of green zone readings. The actions reported in response to children's symptoms and peak flow results similarly varied; however, instances of no action were reported in the setting of yellow and red zone readings. When comparing the "worst days" of children who had ever had a red or yellow PFM reading with those of children who only had exhibited green, there was a nonsignificant trend toward fewer symptoms in the green-only group. Additionally, there was a nonsignificant trend toward a greater likelihood of being sent to the office or school nurse with greater symptoms in the setting of a yellow or red zone reading. Conclusions. On the whole, peak flow readings tended to correspond to asthma disease activity. However, the data indicate that school staff may be more inclined to take action based on their own perceptions of a child's asthma or respond to children's subjective reports of asthma symptoms rather than using a more objective measure of disease activity provided by a peak flow meter.
AB - Background. Self-monitoring of symptoms or peak flow monitoring (PFM) is recommended for all asthma patients and is commonly included in asthma management plans. Limited data are available documenting PFM outcomes in school settings. Method. Three hundred twenty-three urban children with persistent asthma were enrolled in a school-based study that implemented an internet-based asthma monitoring and data collection system. The mean age of the children was 10.0 (SD 2.1) years; 57% were male and 91% were African American. Children logged in daily to an internet-based program to record their asthma symptoms and PFM reading. Teachers logged in daily to confirm the PFM readings. School staff responsible for student health reported actions taken for low PFM readings. Results. A total of 12,245 child reports were completed; 98% (n = 11,974) had corresponding teacher reports, confirming the peak flow meter readings reported by the children. The prevalence of reported asthma symptoms varied across PFM readings; the highest prevalence occurred in the setting of red zone readings, with intermediate prevalence in the setting of yellow zone readings, and lowest prevalence in the setting of green zone readings. The actions reported in response to children's symptoms and peak flow results similarly varied; however, instances of no action were reported in the setting of yellow and red zone readings. When comparing the "worst days" of children who had ever had a red or yellow PFM reading with those of children who only had exhibited green, there was a nonsignificant trend toward fewer symptoms in the green-only group. Additionally, there was a nonsignificant trend toward a greater likelihood of being sent to the office or school nurse with greater symptoms in the setting of a yellow or red zone reading. Conclusions. On the whole, peak flow readings tended to correspond to asthma disease activity. However, the data indicate that school staff may be more inclined to take action based on their own perceptions of a child's asthma or respond to children's subjective reports of asthma symptoms rather than using a more objective measure of disease activity provided by a peak flow meter.
KW - Asthma
KW - Children
KW - Peak flow
KW - School
KW - Wheeze
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U2 - 10.1080/02770900802468509
DO - 10.1080/02770900802468509
M3 - Article
C2 - 19657891
AN - SCOPUS:68849089438
SN - 0277-0903
VL - 46
SP - 535
EP - 540
JO - Journal of Asthma
JF - Journal of Asthma
IS - 6
ER -