Document Detail

Prediction of peak flow values followed by feedback improves perception of lung function and adherence to inhaled corticosteroids in children with asthma.
MedLine Citation:
PMID:  23154987     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Failure to detect respiratory compromise can lead to emergency healthcare use and fatal asthma attacks. The purpose of this study was to examine the effect of predicting peak expiratory flow (PEF) and receiving feedback on perception of pulmonary function and adherence to inhaled corticosteroids (ICS).
METHODS: The sample consisted of 192 ethnic minority, inner-city children (100 Puerto Rican, 54 African-American, 38 Afro-Caribbean) with asthma and their primary caregivers recruited from outpatient clinics in Bronx, New York. Children's PEF predictions were entered into an electronic spirometer and compared with actual PEF across 6 weeks. Children in one study were blinded to PEF (n=88; no feedback) and children in a separate study were able to see PEF (n=104; feedback) after predictions were locked in. Dosers were attached to asthma medications to monitor use.
RESULTS: Children in the feedback condition displayed greater accuracy (p<0.001), less under-perception (p<0.001) and greater over-perception (p<0.001) of respiratory compromise than children in the no feedback condition. This between-group difference was evident soon after baseline training and maintained across 6 weeks. The feedback condition displayed greater adherence to ICS (p<0.01) and greater quick-relief medication use (p<0.01) than the no feedback condition.
CONCLUSIONS: Feedback on PEF predictions for ethnic minority, inner-city children may decrease under-perception of respiratory compromise and increase adherence to controller medications. Children and their families may shift their attention to asthma perception and management as a result of this intervention.
Jonathan M Feldman; Haley Kutner; Lynne Matte; Michelle Lupkin; Dara Steinberg; Kimberly Sidora-Arcoleo; Denise Serebrisky; Karen Warman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thorax     Volume:  67     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-16     Completed Date:  2013-02-11     Revised Date:  2013-03-05    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  1040-5     Citation Subset:  IM    
Ferkauf Graduate School of Psychology/Yeshiva University, Rousso Building, Bronx, NY 10461, USA.
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MeSH Terms
Administration, Inhalation
Adrenal Cortex Hormones / administration & dosage,  therapeutic use*
Analysis of Variance
Anti-Asthmatic Agents / administration & dosage,  therapeutic use*
Asthma / drug therapy*,  ethnology,  physiopathology
New York City
Patient Compliance*
Peak Expiratory Flow Rate*
Urban Population
Grant Support
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Anti-Asthmatic Agents
Comment In:
Thorax. 2012 Dec;67(12):1023-4   [PMID:  22951812 ]
Republished in:
Postgrad Med J. 2013 Feb;89(1048):61-2   [PMID:  23341639 ]

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