Monitoring
Patients are recommended to self-monitor at home on a daily basis by checking and recording the peak expiratory flow rate (PEFR) using a PEFR meter. PEFR results should help the patient adjust medication use as instructed by the doctor using an asthma action plan. PEFR monitoring becomes life-saving for the group of patients who are unable to sense worsening of their asthma. PEFR is not, however, as accurate a measure of pulmonary obstruction as is the forced expiratory volume at 1 second (FEV1) and the FEV1/forced vital capacity (FVC) ratio. The frequency of the testing depends on the severity of the patient's symptoms. In mildly symptomatic, well-controlled asthmatics, the test could be completed once every 1 to 2 years. In more severe asthmatics, testing should be done more frequently to determine medication compliance and the patient's ability to monitor and control symptoms.
Patient Instructions
It is essential to inform the patient that effective home management of symptoms greatly improves outcome. Self-monitoring on a daily basis should be encouraged egby checking and recording peak expiratory flow using the PEFR meter. When discussing these results with their physician subsequent adjustment of medications can be made. It should be emphasised that attending follow-up is essential for a long and healthy life with asthma.
