ADEQUACY OF CONTROL OF ASTHMA IN A GENERAL-PRACTICE - IS MAXIMUM PEAK EXPIRATORY FLOW-RATE A VALID INDEX OF ASTHMA SEVERITY

被引:13
作者
MORRIS, NV
ABRAMSON, MJ
STRASSER, RP
机构
[1] MONASH UNIV, DEPT COMMUNITY MED, CLAYTON, VIC, AUSTRALIA
[2] ALFRED HOSP, MONASH MED SCH, DEPT SOCIAL & PREVENT MED, PRAHRAN, VIC 3181, AUSTRALIA
[3] MONASH UNIV, LATROBE REG HOSP, CTR RURAL HLTH, MOE, VIC 3825, AUSTRALIA
关键词
D O I
10.5694/j.1326-5377.1994.tb126516.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: To evaluate the adequacy of control of asthma in patients attending a general practice; and to examine the validity of peak expiratory flow rate (PEFR) as an index of asthma severity in the context of general practice. Design: Short-term cohort study using indices derived from two weeks of peak flow monitoring to evaluate asthma control. Participants: Known and newly diagnosed asthmatics aged six years or more who presented during the study period for any reason. They were enrolled if baseline forced expiratory volume in one second (FEV(1)) increased by 10% or more after the administration of nebulised salbutamol. Children under the age of 12 years with no initial response to bronchodilator were included if an exercise test performed on another day was positive. Outcome measures: Peak flow criteria for ''mild asthma'' in the Asthma Management Plan, 1989 (Med J Aust 1989; 151: 650-653) were used as the initial definition of ''adequate control'' The definition of ''adequate control'' was modified to variability less than 20% and a minimum PEFR of 50% or more of mean predicted value. Results: There was no association between variability and maximum PEFR, but variability was strongly correlated with minimum PEFR (R = -0.60; P < 0.0005). Asthma was adequately controlled in 68% of the participants. Conclusion: Current guidelines with respect to the peak flow indices used in the classification of the severity of asthma need to be re-evaluated and probably changed for application in general practice.
引用
收藏
页码:68 / 71
页数:4
相关论文
共 24 条
[1]   THE PREVALENCE OF ASTHMA IN VICTORIAN ADULTS [J].
ABRAMSON, M ;
KUTIN, J ;
BOWES, G .
AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE, 1992, 22 (04) :358-363
[2]  
[Anonymous], 1987, Am Rev Respir Dis, V136, P1285
[3]  
B. T. Association, 1982, BMJ, V285, P1251
[4]   LUNG-FUNCTION IN AN AUSTRALIAN POPULATION - SPIROMETRIC STANDARDS FOR NON-SMOKING ADULTS [J].
GIBSON, J ;
GALLAGHER, H ;
JOHANSEN, A ;
WEBSTER, I .
MEDICAL JOURNAL OF AUSTRALIA, 1979, 1 (07) :292-295
[5]   COMPARISON OF NORMAL AND ASTHMATIC CIRCADIAN-RHYTHMS IN PEAK EXPIRATORY FLOW-RATE [J].
HETZEL, MR ;
CLARK, TJH .
THORAX, 1980, 35 (10) :732-738
[6]   LUNG-FUNCTION VALUES FROM A LONGITUDINAL-STUDY OF HEALTHY-CHILDREN AND ADOLESCENTS [J].
HIBBERT, ME ;
LANNIGAN, A ;
LANDAU, LI ;
PHELAN, PD .
PEDIATRIC PULMONOLOGY, 1989, 7 (02) :101-109
[7]   THE DISTRIBUTION OF PEAK EXPIRATORY FLOW VARIABILITY IN A POPULATION-SAMPLE [J].
HIGGINS, BG ;
BRITTON, JR ;
CHINN, S ;
JONES, TD ;
JENKINSON, D ;
BURNEY, PGJ ;
TATTERSFIELD, AE .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1989, 140 (05) :1368-1372
[8]   MANAGEMENT OF ASTHMA IN GENERAL-PRACTICE [J].
HORN, CR ;
COCHRANE, GM .
RESPIRATORY MEDICINE, 1989, 83 (01) :67-70
[9]   MORTALITY FROM ASTHMA - A NEW EPIDEMIC IN NEW-ZEALAND [J].
JACKSON, RT ;
BEAGLEHOLE, R ;
REA, HH ;
SUTHERLAND, DC .
BRITISH MEDICAL JOURNAL, 1982, 285 (6344) :771-774
[10]   TRENDS IN AUSTRALIAN MORTALITY OF ASTHMA, 1979-1985 [J].
JENKINS, MA ;
HURLEY, SF ;
JOLLEY, DJ ;
OLIVER, RG ;
MCLEAN, AJ ;
MCNEIL, JJ .
MEDICAL JOURNAL OF AUSTRALIA, 1988, 149 (11-12) :620-&