The Effects of Regular Peak Flow Meter Utilisation on Asthma Self-Management

This project aims to explore the prospect of a pharmacist-instigated asthma self-management intervention; whether the introduction of a Peak Flow Meter with appropriate education can improve asthma control and engagement in asthma self-management. The study was designed as a parallel before-and-after randomised controlled-intervention pilot study, conducted in four separate steps. Step 1: The first meeting involved a guided survey (part 1: to gather the subjects’ baseline information) as well as two validated questionnaires (part 2: to assess the subject’s asthma knowledge and asthma control, and all participants were provided with asthma education. Step 2: The second meeting involved the completion of the second survey by all participants (only part 2). Participants allocated into the interventional group were provided with a peak flow meter, a diary to record their measurements, and education on how to use the device. The participants were encouraged to measure their peak expiratory flow every morning and whenever they feel that they may be experience airflow limitation. The participants allocated into the control group were not given any information about the PFM, however both groups’ asthma management was reviewed. Step 3: At the third meeting all participants were asked to complete a third survey (only part 2). Participants in the control group were now provided with a PFM, a diary to record PEF measurements, and education on how to use the device (as per intervention group in Step 2). In a follow-up, all participants were asked to complete a fourth survey (only part 2). The meetings took place at a time and location convenient to the participant and researcher at 4-week intervals (+/-1 week), which took approximately 30 minutes per meeting. Asthma education provided in the first meeting acted as a longitudinal control in order to exclude any improvement of asthma self-management due to asthma education during the introduction of the peak flow meter. Information about asthma and peak flow meter use was obtained through standardised material provided by the Asthma Foundation, the Pharmaceutical Society of Australia, evidence based researched information (e.g. journal articles, Asthma Management Handbook), and education delivered during the university course Bachelor of Pharmacy at Charles Darwin University. Information provided included an explanation of asthma symptoms, aetiology and pathophysiology, relevant information about medications (e.g. relievers, preventers and symptom controllers) and asthma devices (including information about inhaler techniques and maintenance, benefits of certain devices, etc.). Further information was given about the perception of asthma symptoms, triggers, instructions on how to manage an asthma attack, and when to consult a doctor. Asthma management information comprised the treatment goals and self-management information on medication storage, breathing exercises, regular doctor reviews, AAP use, lifestyle modifications, exercise as well as diet and other medication that may influence asthma control. Further information was provided if requested such as on exercise-induced asthma, asthma-related diet and other considerations. The information was provided in accordance to individual’s treatment and needs. In addition, the subject inhaler technique was assessed, any questions were answered and written educational information was offered.