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 NICE CKS. 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 NICE CKS. However, PEF measurements do have specific roles for certain people NICE CKS. 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 NICE CKS. Action plans that incorporate PEF measurement can be beneficial for some adults NICE CKS. 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 NICE CKS. Long-term PEF monitoring is specifically recommended only for people with severe asthma or those with impaired perception of airflow limitation NICE CKS. For complete asthma control, lung function, including PEF, should ideally be more than 80% predicted or best NICE NG245.