Prevention

• If the PEFR is
  • ≤ 70% or ≥ 20% diurnal variation - double inhaled steroid dose
  • ≤ 50% - steroid course
  • ≤ 30% - seek urgent treatment

• A peak-flow based action plan reduces the need for urgent treatment. There is no clear effect on number of hospital admissions. ^a
• A symptom-based action plan is not clearly better than giving no advice. ^a

A peak-flow based action plan reduces the need for urgent treatment

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
acute asthma a	PEFR action plan	no plan	urgent treatment at weeks	40%	73% (33% to 89%)	3 (2 to 8)