Fibbing asthmatic children a health hazard

Fibbing asthmatic children a health hazard

Just over 50 years ago British bioengineer Martin Wright invented the mechanical peak flow meter, a simple device to aid in the diagnosis and management of asthma. It is designed to measure how fast air can be expelled from the lungs - this gives the person with asthma an objective assessment of how well their condition is under control. In New Zealand, 40,000 peak flow meters are distributed every year, suggesting the ongoing importance of the device in asthma management.

Specific reasons to use a peak flow meter and a written diary of daily readings include:

• To assist in the diagnosis of asthma and its severity
• To determine how well current asthma medication is working
• To assess response to changes in asthma therapy
• To help identify triggers (such as allergens in occupational settings)
• To help avoid asthma exacerbations by detecting decreasing lung function early, and potentially altering treatment

Potential problems include patient compliance – using a mechanical peak flow meter necessitates the keeping of a written peak flow diary. A study has found that only 50% of children’s peak flow diary entries were accurate after 3 weeks of recording, mainly because the children began making up readings. Well-known general practitioner Dr Glenn Twentyman makes the observation, “Keeping a peak flow diary is just like homework for a child, sometimes they just don’t want to do it. Unfortunately, fabricated diary entries can lead to under- or over-dosing of asthma medication for that child”.

Much better compliance is achieved using electronic peak flow meters that record every reading automatically, thus removing the chore of updating diaries. Research using the nSpire Piko-1 electronic peak flow meter (which is now available in New Zealand) found that people used it as directed up to 93% of the time. Furthermore, data falsifications - and related asthma treatment errors - were eliminated.

In summary, peak flow monitoring remains an important aspect of a broader asthma management plan. The advent in New Zealand of user-friendly electronic peak flow meters will certainly contribute convenience and reliability to the process, especially with children.

The nSpire Piko-1 electronic peak flow meter is available from pharmacies, and via the online shop at www.allergy.org.nz

ENDS

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