What role do peak flow measurements play in the ongoing management of asthma in primary care?

In the ongoing management of asthma in primary care, routine regular peak expiratory flow (PEF) monitoring is generally not recommended ³. This is because it has been associated with worse quality of life and may induce anxiety in some individuals if readings are not consistently high ³. However, PEF measurements do have specific roles for certain people ³. A minority of people with asthma may benefit from regular PEF measurement, particularly if they have a poor perception of changes in their airways and are therefore at risk of delaying treatment for asthma exacerbations ³. Action plans that incorporate PEF measurement can be beneficial for some adults ³. Short-term PEF monitoring may be used to assess the response to treatment, evaluate triggers for worsening symptoms (including occupational triggers), or to establish a baseline for personalised asthma action plans ³. Long-term PEF monitoring is specifically recommended only for people with severe asthma or those with impaired perception of airflow limitation ³. For complete asthma control, lung function, including PEF, should ideally be more than 80% predicted or best ¹.