THE ROLE OF MEASURING FORCED EXPIRATORY VOLUME IN ONE-SECOND IN DETERMINING THERAPEUTIC CHANGES MADE IN AN ASTHMA-CLINIC IN GENERAL-PRACTICE

In order to determine whether spirometric measurements in a primary care asthma clinic added useful information to symptom assessment and peak flow recordings, a retrospective audit of manual case records was conducted on patients attending an urban general practice asthma clinic. Sixty-three patients were identified in whom 108 increases in treatment at the clinic had been recorded and the associated determinants of these changes were extracted from their case notes. Therapeutic changes associated with the following determinants alone were only found in single instances: presence of or changes in symptoms, inhaler technique deficiency, forced expiratory volume in 1s (FEV,) less than 75% of the predicted value and peak expiratory flow (PEF) rate less than 75% of the predicted value. In no instance did changes in FEV, or in PEF alone occur. The addition of spirometric measurements in this sample of patients only made an obvious difference to decision-making in four instances (4%). Therefore, the role of spirometers in the management of asthma in general practice needs further consideration and clarification on a wider scale before limited resources, whether in terms of time or money, are committed to their use.