Monitoring the patient with asthma: An evidence-based approach
- 1 July 2000
- journal article
- review article
- Published by Elsevier BV in Journal of Allergy and Clinical Immunology
- Vol. 106 (1), 17-26
- https://doi.org/10.1067/mai.2000.108307
Abstract
The monitoring of symptoms, airflow obstruction, and exacerbations is essential to asthma management. Patients who practice self-monitoring in conjunction with use of a written action plan and regular medical review have significantly fewer hospitalizations, emergency department visits, and lost time from work. Either symptom monitoring or peak expiratory flow monitoring is satisfactory, provided the results are interpreted with reference to the patient's own baseline asthma status. Regular monitoring by physicians also improves health outcomes for patients, provided the physician is systematic and monitors control, medications, and skills at regular intervals. Additional monitoring tools are under evaluation, and these include measures of airway responsiveness, airway inflammation, and Internet-based monitoring systems. Administrators need to monitor the quality and cost of care, as well as compliance with national management guidelines. Assessment of the hospitalization rate and regular audit may achieve these aims in the hospital setting. The best way to assess and monitor asthma in primary care remains an unresolved yet crucial issue because primary care physicians manage the vast burden of illness caused by asthma. Monitoring asthma outcomes is an essential step toward the successful implementation of national guidelines for the management of asthma.Keywords
This publication has 59 references indexed in Scilit:
- Risk of overtreatment with current peak flow criteria in self-management plans. Dutch CNSLD Study Group. Chronic Non-Specific Lung DiseaseEuropean Respiratory Journal, 1998
- Adverse Reactions to Peak Flow MonitoringRespiration, 1998
- A controlled assessment of an asthma self-management plan involving a budesonide dose regimen. OPTIONS Research GroupEuropean Respiratory Journal, 1996
- Compliance with and accuracy of daily self-assessment of peak expiratory flows (PEF) in asthmatic subjects over a three month periodEuropean Respiratory Journal, 1996
- Economic analysis of two structured treatment and teaching programs on asthmaAllergy, 1996
- Improving asthma documentation in a paediatric emergency departmentJournal of Paediatrics and Child Health, 1995
- Quality improvement in health care organizations: A general systems perspectiveBehavioral Science, 1995
- Chemosensitivity and Perception of Dyspnea in Patients with a History of Near-Fatal AsthmaNew England Journal of Medicine, 1994
- A research method to induce and examine a mild exacerbation of asthma by withdrawal of inhaled corticosteroidClinical and Experimental Allergy, 1992
- Evaluation of peak flow and symptoms only self management plans for control of asthma in general practice.BMJ, 1990