Patient adherence to asthma self-management varies, but it is often poor with adherence tending to increase in proportion to the severity and duration of an asthmatic episode. Researchers in New Zealand suggest this underscores the importance of self-management among patients with severe asthma.

 “Symptoms are more important than peak expiratory flow (PEF) in prompting patients to alter treatment,” say investigators from the University of Otago in Dunedin and Christchurch Hospital. They analysed diary data from 165 patients participating in an earlier two-year study.

In that study, participants regularly revised their asthma self-management plans in combination with PEF and symptoms to manage intercurrent episodes. They recorded changes in diaries.

 Self-management included instructions on when to increase inhaled corticosteroid dosage or start oral prednisone as asthmatic episodes increased in severity. In their analysis, the researchers identified when patients increased dosage or started prednisone. The changes were correlated to those in PEF and/or symptoms.

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