Thursday, July 12, 2007
This presentation is part of : Chronic Care Initiatives
Improved Health Outcomes with Peak Flow Monitoring for Children with Asthma
Patricia V. Burkhart, PhD, RN, Mary Kay Rayens, PhD, and Marsha G. Oakley, MSN, RN. College of Nursing, University of Kentucky, Lexington, KY, USA
Learning Objective #1: identify evidence to support teaching peak flow monitoring as part of asthma self-management for children.
Learning Objective #2: discuss the importance of children’s adherence to daily self-monitoring of asthma symptoms.

Purpose:  Health outcomes were assessed for school-age children with persistent asthma who were taught daily self-monitoring of peak flow [PFM].
Method and Sample: The effect of daily PFM on asthma episode rates, health care utilization, and missed school days because of asthma was evaluated over time in a convenience sample of 77 children with asthma. During Week 1, the children (who previously relied on symptom monitoring) were taught to use an electronic peak flow meter that assessed at-home adherence to daily PFM during the 16-week study. The Children’s Health Survey for Asthma Parent Report measured prevalence of asthma episodes, health care utilization, and missed school days due to asthma for the previous two-month period, administered at Weeks 1, 8, and 16. Changes in nominal measures of health over time were assessed using generalized estimating equations (GEE) modeling.
Results: Significant clinical findings included decreases from baseline to Week 16 in the prevalence of one or more asthma episodes (p = .0002), physician or clinic visits for asthma (p = .0002), missed school days (p = .002), and emergency department visits (p = .03). Of those children who were at least 80% adherent to PFM, 33% had an asthma episode during the last 8 weeks, whereas for those who did PFM less, the asthma episode rate was 57% (X2 = 4.3, p = .04).
Conclusions: Objective self-monitoring of asthma symptoms may have increased children’s awareness of their disease status leading to early intervention that resulted in fewer asthma episodes, missed school days, and acute care visits for asthma. The results are clinically significant in reducing pediatric asthma morbidity and contributing to evidence-based practice for childhood asthma.                                                                        
This study was supported by Grant # R15 NR08106-01 from the National Institute of Nursing Research, National Institutes of Health.