Information provided by meters should be part of self management plan

EDITOR—Reddel et al found high rates of adherence to a peak flow monitoring regimen and attribute this to the use of electronic devices.1 But is this the entire answer?

The authors note that the electronic peak flow monitoring took place in the context of regular visits and titration of drugs according to the peak flow data. They comment that “the context in which monitoring is undertaken may influence adherence” and note the importance of the perceived usefulness of peak flow data in ensuring that patients use these devices.

Might it be the design of the intervention—with regular follow up, clear self management plans, and clear linking of peak flow readings with drug doses—rather than the electronic measuring devices themselves that accounted for the high levels of adherence? In the absence of a comparator group that used only traditional devices it is …