BMJ 1994;308:1370-1 (21 May)

Letters

Caring for patients with asthma Teaching self management takes time

EDITOR, - The Grampian asthma study concluded that peak flow meters and self management plans offered "little clinical benefit."1 Closer examination of the methods shows that the self management plans used by Beasley et al.2 and by us3 were not used and that the crucial ingredient of doubling the dose of inhaled steroid as the peak flow falls was not adhered to. Our recently published work confirms the importance of this step. If patients manage themselves by increasing bronchodilators only, as occurred in one arm of our study, the outcome is not as impressive.4

The self management plans of the Grampian asthma study focused on when to start oral steroids and when to seek immediate medical help. Such a plan is more suited to preventing admission and increasing doctor contact rather than reducing morbidity. It is therefore no surprise that the number of consultations with general practitioners rose in the . . . [Full text of this article]


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Relevant Article

Effectiveness of routine self monitoring of peak flow in patients with asthma
N Drummond, M Abdalla, J A G Beattie, J K Buckingham, T Lindsay, L M Osman, S J Ross, A Roy-Chaudhury, I Russell, M Turner, J A R Friend, J S Legge, and J G Douglas
BMJ 1994 308: 564-567. [Abstract] [Full Text]

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