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Department of
Paediatrics, Division of Paediatric Pulmonology, Isala Klinieken,
Weezenlanden Hospital, PO Box 10500, 8000 GM Zwolle, The Netherlands
Correspondence to: Dr P L P Brand P.L.P.Brand{at}isala.nl
Received 14 September 2000; Returned to authors 21 October 2000; Revised version received 6 November 2000; Accepted for publication 24 November 2000
BACKGROUND
A study was
undertaken to investigate the compliance with and accuracy of peak flow
diaries in childhood asthma.
METHODSForty
asthmatic children (5-16 years) were asked to perform peak flow
measurements twice daily for 4 weeks by means of an electronic peak
flow meter and to record values in a written diary. Patients and
parents were unaware that the device stored the peak flow values on a
microchip. In random order, half of the patients were only told that
the device allowed for more accurate assessment of peak flow while the
other half were told that accurate recording of peak flow was important
because the results would be used in guiding adjustments to treatment.
Data in the written diary (reported data) were compared with those from
the electronic diary (actual data).
RESULTSIn the entire
study population the mean (SD) actual compliance (77.1 (20.5)%) was
much lower than the mean reported compliance (95.7 (9.1)%) (95% CI
for difference 12.7% to 24.4%) The percentage of correct peak flow
entries decreased from 56% to <50% from the first to the last study
week (p<0.04), mainly as a result of an increase in self-invented peak
flow entries. Results were comparable for both groups. For incorrect
peak flow entries the mean difference between written and
electronically recorded entries ranged from -72 to 34 l/min per patient.
CONCLUSIONSPeak flow
diaries kept by asthmatic children are unreliable. Electronic peak flow
meters should be used if peak flow monitoring is required in
children with asthma.
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