Home monitoring devices encourage people to actively participate in their health care management. In addition, access to more data may help to make better decisions, which may ultimately lead to better health outcomes. The primary focus of this article will be on blood glucose, blood pressure, prothrombin time, and peak flow meters. The empirical evidence on the accuracy and usefulness of these home monitoring devices is discussed. Based on the evidence from the literature, erroneous reporting of the readings by the patients is a major concern. Therefore, primary practitioners are encouraged to consult with patients’ log books and their meters (if memory feature is available), instead of relying solely on self-reported values. Patients also need to be educated and trained adequately about the proper measurement technique and relevance and interpretation of the readings. Continuing education is necessary regarding the behavioral and therapeutic changes patients should carry out in accordance with performing regular home monitoring.
Get full access to this article
View all access options for this article.
References
1.
1. Levy S. The boom in home diagnostics. Drug Topics. 2003;3: 33.
2.
2. Pal S. Home test market reaches $1.4 billion. US Pharm. 1996;23: 3.
3.
3. Lewis D. Five facts about home medical tests. Family Safety and Health. 2002;60: 4.
4.
4. DCCT Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329: 977-986.
5.
5. UK Prospective Diabetes Study Group. Intensive blood-glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352: 837-853.
6.
6. Lerman-Garber I, Lopez-Ponce A, Murcio Flores RA, et al. Comparing easy and accessible parameters of glycemic control in type 2 diabetes. Rev Invest Clin. 2001;53: 518-525.
7.
7. Portable blood glucose monitors. Health Devices. 2000;29: 201-232.
8.
8. Miller CD, Barnes CS, Phillips LS, et al. Rapid a1c availability improves clinical decision-making in an urban primary care clinic. Diabetes Care. 2003;26: 1158-1163.
9.
9. Rector TS, Venus PJ, Thayer SR. Use of home hemoglobin A1c test kits to monitor the effectiveness of diabetes care. Jt Comm J Qual Improv. 2001;27: 265-277.
10.
10. Goldstein DE, Little RR, Lorenz RA, et al. Tests of glycemia in diabetes. Diabetes Care. 2003;26(suppl 1): S106-S108.
11.
11. Fleming DR. Accuracy of blood glucose monitoring for patients: what it is and how to achieve it. Diabetes Educ. 1994;20: 495-498, 500.
12.
12. Gallichan M. Practice point. The diabetes specialist nurse: detective and troubleshooter. Practical Diabetes International. 1999;16: 23-26.
13.
13. Haag BI, Leed LA. Susceptibility of two new glucose test strips to testing errors. Diabetes. 1999;48(suppl 1): A834.
14.
14. Lewandrowski KB, Dan L. Effects of small sample volumes and interfering substances on two glucose meters. Diabetes. 1999;48(suppl 1): A1834.
15.
15. Velazquez F, Wright L, Ko V. Influence of glucose test strip design on the accuracy of the test result. Diabetes. 1999;48(suppl 1): A1527.
16.
16. Demers J, Kane MP, Bakst G, et al. Accuracy of home blood glucose monitors using forearm blood samples: Free Style versus One Touch Ultra. Am J Health Syst Pharm. 2003;60: 1130-1135.
17.
17. Fineberg SE, Berganstal RM, Bernstein RM. Use of an automated device for alternate site blood glucose monitoring. Diabetes Care. 2001;24: 1217-1220.
18.
18. Jungheim K, Koschinsky T. Risky delay of hypoglycemia detection by glucose monitoring at the arm. Diabetes Care. 2001;24: 1303-1304.
19.
19. Ellison JM, Stegmann JM, Colner SL. Rapid changes in postprandial blood glucose produce concentration differences at finger, forearm, and thigh sampling sites. Diabetes Care. 2002;25: 961-964.
20.
20. Food and Drug Administration. Clinical chemistry and clinical toxicology devices panel meeting summary for Oct 29, 2001. Available at: http://www.fda.gov/cdrh/panel/summary/chem110601.html Accessed September 22, 2003.
21.
21. McGarraugh G, Schwartz S, Weinstein R. Glucose measurements using blood extracted from the forearm and the finger. Response to Jungheim and Koschinsky. Diabetes Care. 2001;24: 1304-1305.
22.
22. Mazze RS, Lucido D, Shamoon H. Psychological and social correlates of glycemic control. Diabetes Care. 1984;7: 360-366.
23.
23. Hoskins PL, Alford JB, Handelsman DJ, et al. Comparison of different models of diabetes care on compliance with self-monitoring of blood glucose by memory glucometer. Diabetes Care. 1988;11: 719-724.
24.
24. Johnson SB. Methodological issues in diabetes research. Measuring adherence. Diabetes Care. 1992;15: 1658-1667.
25.
25. Butler RN, Rubenstein AH, Gracia AM, et al. Type 2 diabetes: patient education and home blood glucose monitoring. Roundtable discussion part 3. Geriatrics. 1998;53: 60, 63-64, 67.
26.
26. Dorchy H, Roggemans MP. Improvement of the compliance with blood glucose monitoring in young insulin-dependent diabetes mellitus patients by the Sensor link system. Diabetes Res Clin Pract. 1997;36: 77-82.
27.
27. Patrick AW, Gill GV, MacFarlane IA, et al. Home glucose monitoring in type 2 diabetes: is it a waste of time? Diabet Med. 1994;11: 62-65.
28.
28. Gallichan M. Self monitoring of glucose by people with diabetes: evidence based practice. BMJ. 1997;314: 964-967.
29.
29. Cox DJ, Kovatchev BP, Julian DM, et al. Frequency of severe hypoglycemia in insulin-dependent diabetes mellitus can be predicted from self-monitoring blood glucose data. J Clin Endocrinol Metab. 1994;79: 1659-1662.
30.
30. Kovatchev BP, Cox DJ, Gonder-Frederick LA, et al. Assessment of risk for severe hypoglycemia among adults with IDDM: validation of the low blood glucose index. Diabetes Care. 1998; 21: 1870-1875.
31.
31. American Diabetes Association. Consensus statement: self-monitoring of blood glucose. Diabetes Care. 1996;19(suppl 1): S62-S66.
32.
32. Gaster B, Hirsch IB. The effects of improved glycemic control on complications in type 2 diabetes. Arch Intern Med. 1998;158: 134-140.
33.
33. Klein R. Hyperglycemia and microvascular and macrovascular disease in diabetes. Diabetes Care. 1995;18: 258-268.
34.
34. Klein R, Klein BE, Moss SE. Relation of glycemic control to diabetic microvascular complications in diabetes mellitus. Ann Intern Med. 1996;124(1 pt 2): 90-96.
35.
35. Ohkubo Y, Kishikawa H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract. 1995;28: 103-117.
36.
36. Abraira C, Colwell J, Nuttall F, et al. Cardiovascular events and correlates in the Veterans Affairs Diabetes Feasibility Trial. Veterans Affairs Cooperative Study on Glycemic Control and Complications in Type II Diabetes. Arch Intern Med. 1997;157: 181-188.
37.
37. Rindone JP, Austin M, Luchesi J. Effect of home blood glucose monitoring on the management of patients with non-insulin dependent diabetes mellitus in the primary care setting. Am J Manag Care. 1997;3: 1335-1338.
38.
38. Wieland LD, Vigil JM, Hoffman RM, et al. Relationship between home glucose testing and hemoglobin Alc in type II diabetes patients. Am J Health Syst Pharm. 1997;54: 1062-1065.
39.
39. Wing RR, Lamparski DM, Zaslow S, et al. Frequency and accuracy of self-monitoring of blood glucose in children: relationship to glycemic control. Diabetes Care. 1985;8: 214-218.
40.
40. Allen BT, DeLong ER, Feussner JR. Impact of glucose self-monitoring on non-insulin-treated patients with type II diabetes mellitus: randomized controlled trial comparing blood and urine testing. Diabetes Care. 1990;13: 1044-1050.
41.
41. Klein CE, Oboler SK, Prochazka A, et al. Home blood glucose monitoring: effectiveness in a general population of patients who have non-insulin-dependent diabetes mellitus. J Gen Intern Med. 1993;8: 597-601.
42.
42. Evans JMM, Newton RW, Ruta DA, et al. Frequency of blood glucose monitoring in relation to glycemic control: observational study with diabetes database. BMJ. 1999;319: 83-86.
43.
43. Muchmore DB, Springer J, Miller M. Self-monitoring of blood glucose in overweight type 2 diabetic patients. Acta Diabetol. 1994;31: 215-219.
44.
44. Kibriya MG, Ali L, Banik NG, et al. Home monitoring of blood glucose (HMBG) in type-2 diabetes mellitus in a developing country. Diabetes Res Clin Pract. 1999;46: 253-257.
45.
45. Nathan DM. Inferences and implications: do results from the Diabetes Control and Complications Trial apply in NIDDM? Diabetes Care. 1995;18: 251-257.
46.
46. Meier JL, Swislocki AL, Lopez JR, et al. Reduction in self-monitoring of blood glucose in persons with type 2 diabetes results in cost savings and no change in glycemic control. Am J Manag Care. 2002;8: 557-565.
47.
47. Abraira C, Colwell JA, Nuttall FQ, et al. Veterans Affairs Cooperative Study on glycemic control and complications in type II diabetes (VA CSDM): results of the feasibility trial. Veterans Affairs Cooperative Study in Type II Diabetes. Diabetes Care. 1995;18: 1113-1123.
48.
48. Shorr RI, Ray WA, Daugherty JR, et al. Individual sulfonylureas and serious hypoglycemia in older people. J Am Geriatr Soc. 1996;44: 751-755.
49.
49. Steel LG. Identifying technique errors: self-monitoring of blood glucose in the home setting. J Gerontol Nurs. 1994;20: 9-12.
50.
50. Windecker R, Heinemann L, Sawicki PT. Self monitoring of blood glucose in blind diabetic patients. Diabet Med. 1997;14: 703-706.
51.
51. Delamater AM, Davis SG, Bubb J, et al. Self-monitoring of blood glucose by adolescents with diabetes: technical skills and utilization of data. Diabetes Educ. 1989;15: 56-61.
52.
52. Delamater AM, Bubb J, Davis SG, et al. Randomized prospective study of self-management training with newly diagnosed diabetic children. Diabetes Care. 1990;13: 492-498.
53.
53. Poirier JY, Le Prieur N, Campion L, et al. Clinical and statistical evaluation of self-monitoring blood glucose meters. Diabetes Care. 1998;21: 1919-1924.
54.
54. Karter AJ, Ferrara A, Darbinian JA, et al. Self-monitoring of blood glucose: language and financial barriers in a managed care population with diabetes. Diabetes Care. 2000;23: 477-483.
55.
55. Kikuya M, Chonan K, Imai Y, et al. Accuracy and reliability of wrist-cuff devices for self-measurement of blood pressure. J Hypertens. 2002;20: 573-578.
56.
56. Heise TK, Grobel B, Heinemann L, et al. A cross-over evaluation of different methods and devices to measure blood pressure in type 1 diabetic patients with nephropathy. Blood Press Monit. 2000;5: 175-180.
57.
57. Latman NS, Latman A. Evaluation of instruments for noninvasive blood pressure monitoring of the wrist. Biomed Instrum Technol. 1997;31: 63-68.
58.
58. 1999 World Health Organization International Society of hypertension guidelines for the management of hypertension. J Hypertens. 1999;17: 151-183.
59.
59. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. NIH publication no. 03-5233. Bethesda, Md: National Heart, Lung, and Blood Institute; 2003.
60.
60. Reims H, Fossum E, Kjeldsen SE, et al. Home blood pressure monitoring: current Knowledge and directions for future research. Blood Press. 2001;10: 271-287.
61.
61. Brook RD. Home blood pressure: accuracy is independent of monitoring schedules. Am J Hypertens. 2000;13: 625-631.
62.
62. Yarows SA, Julius S, Pickering TG. Home blood pressure monitoring. Arch Intern Med. 2000;160: 1251-1264.
63.
63. Johnson KA, Partsch DJ, Rippole LL, et al. Reliability of self-reported blood pressure measurements. Arch Intern Med. 1999;159: 2689-2693.
64.
64. Nordmann A, Frach B, Walker T, et al. Reliability of patients measuring blood pressure at home: prospective observational study. BMJ. 1999;319: 1172.
65.
65. Cheng C, Studdiford JS, Chambers CV, et al. The reliability of patient self-reported blood pressures. Am J Hypertens. 2001;14(suppl 1): 38-39.
66.
66. Schmidt GR, Pitterle ME, Schuna AA. Home blood pressure readings in clinical hypertension research. Clin Pharm. 1986;5: 917-920.
67.
67. Gould BA, Kieso HA, Hornung R, et al. Assessment of the accuracy and role of self-recorded blood pressures in the management of hypertension. Br Med J (Clin Res Ed). 1982;285: 1691-1694.
68.
68. Kjeldsen SE, Hedner T, Syvertsen JO, et al. Comparison of home and office blood pressure in treated hypertensives in the Nordic Diltiazem (NORDIL) study. Blood Press. 2002;11: 371-376.
69.
69. Kleinert HD, Harshfield GA, Pickering TG, et al. What is the value of home blood pressure measurement in patients with mild hypertension? Hypertension. 1984;6: 574-578.
70.
70. Zarnke KB, Feagan BG, Mahon JL, et al. A randomized study comparing a patient-directed hypertension management strategy with usual office-based care. Am J Hypertens. 1997;10: 58-67.
71.
71. Santilli GM, English JC. Home blood pressure readings in borderline hypertensive patients. Fam Pract Res J. 1990;10: 97-103.
72.
72. Davidson RA. Home monitoring service was more effective than usual care in patients with essential hypertension. ACP J Club. 2002;136: 13.
73.
73. Midanik LT, Resnick B, Hurley LB, et al. Home blood pressure monitoring for mild hypertensives. Public Health Rep. 1991;106: 85-90.
74.
74. Edmonds D, Foerster E, Groth H, et al. Does self-measurement of blood pressure improve patient compliance in hypertension? J Hypertens Suppl. 1985;3: 31-34.
75.
75. Nessman DG, Carnahan JE, Nugent CA. Increasing compliance: patient-operated hypertension groups. Arch Intern Med. 1980;140: 1427-1430.
76.
76. Jeck T, Edmonds D, Mengden T, et al. Performing self-measurement of blood pressure: a patient survey. Schweizerische Rundschau fur Medizin Praxis. 1991;80: 456-461.
77.
77. Tsuji I, Imai Y, Nagai K, et al. Proposal of reference values for home blood pressure measurement: prognostic criteria based on a prospective observation of the general population in Ohasama, Japan. Am J Hypertens. 1997;10: 409-418.
78.
78. Okumiya K, Matsubayashi K, Wada T, et al. A U-shaped association between home systolic blood pressure and four-year mortality in community-dwelling older men. J Am Geriatr Soc. 1999;47: 1415-1421.
79.
79. Ohkubo T, Imai Y, Tsuji I, et al. Home blood pressure measurement has a stronger predictive power for mortality than does screening blood pressure measurement: a population-based observation in Ohasama, Japan. J Hypertens. 1998;16: 971-975.
80.
80. Sakuma M, Imai Y, Tsuji I, et al. Predictive value of home blood pressure measurement in relation to stroke morbidity: a population-based pilot study in Ohasama, Japan. Hypertens Res. 1997;20: 167-174.
82. Soghikian K, Casper SM, Fireman BH, et al. Home blood pressure monitoring: effect on use of medical services and medical care costs. Med Care. 1992;30: 855-865.
83.
83. Broege PA, James GD, Pickering TG. Management of hypertension in the elderly using home blood pressures. Blood Press Monit. 2001;6: 139-144.
84.
84. Aylett M, Marples G, Jones K. Home blood pressure monitoring: its effect on the management of hypertension in general practice. Br J Gen Pract. 1999;49: 725-728.
85.
85. Naef RW, Perry KG, Magann EF, et al. Home blood pressure monitoring for pregnant patients with hypertension. JPernatol. 1998;18: 226-229.
86.
86. Ross-McGill H, Hewison J, Hirst J, et al. Antenatal home blood pressure monitoring: a pilot randomized controlled trial. Br J Obstet Gynaecol. 2000;107: 217-221.
87.
87. Taylor RS, Freeman L, North RA. Evaluation of ambulatory and self-initiated blood pressure monitors by pregnant and postpartum women. Hypertens Pregnancy. 2001;20: 25-33.
88.
88. Peek M, Shennan A, Halligan A, et al. Hypertension in pregnancy: which method of blood pressure measurement is most predictive of outcome? Obstet Gynecol. 1996;88: 1030-1033.
89.
89. Masding MG, Jones JR, Bartley E, et al. Assessment of blood pressure in patients with type 2 diabetes: comparison between home blood pressure monitoring, clinic blood pressure measurement and 24-h ambulatory blood pressure monitoring. Diabetes Med. 2001;18: 431-437.
90.
90. Gompels C, Savage D. Home blood pressure monitoring in diabetes. Arch Dis Child. 1992;67: 636-639.
91.
91. Haas S. Prevention of venous thromboembolism: recommendations based on the International Consensus and the American College of Chest Physicians Sixth Consensus Conference on Antithrombotic Therapy. Clin Appl Thromb Hemost. 2001;7: 171-177.
92.
92. Hirsh J, Dalen JE, Anderson DR, et al. Oral anticoagulants: mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest. 1998;114(suppl 5): 445S-469S.
93.
93. Reed C, Rickman H. Accuracy of international normalized ratio determined by portable whole-blood coagulation monitor versus a central laboratory. Am J Health Syst Pharm. 1999;56: 1619-1623.
94.
94. Rosendaal FR, Cannegieter SC, van der Meer FJ, et al. A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost. 1993;69: 236-239.
95.
95. Oral Anticoagulation Monitoring Study Group. Point-of-care prothrombin time measurement for professional and patient self-testing use: a multicenter clinical experience. Am J Clin Pathol. 2001;115: 288-296.
96.
96. Koertke H, Minami K, Bairaktaris A, et al. INR self-management following mechanical heart valve replacement. J Thromb Thrombolysis. 2000;9(suppl 1): S41-S45.
98. Leaning KE, Ansell JE. Advances in the monitoring of oral anticoagulation: point-of-care testing, patient self-monitoring, and patient self-management. J Thromb Thrombolysis. 1996;3: 377-383.
99.
99. Lamminen H, Niiranen S, Niemi K, et al. Personal health care and the new media in anticoagulant treatment. Scand J Prim Health Care. 2002;20: 123-125.
100.
100. Hasenkam JM, Knudsen L, Kimose HH, et al. Practicability of patient self-testing of oral anticoagulant therapy by the international normalized ratio (INR) using a portable whole blood monitor: a pilot investigation. Thromb Res. 1997;85: 77-82.
101.
101. Engh CA Jr, Culpepper WJ, Charette PA, et al. Patient self-testing of prothrombin time after hip arthroplasty. J South Orthop Assoc. 2001;10: 140-146.
102.
102. Sunderji R, Campbell L, Shalansky K, et al. Outpatient self-management of warfarin therapy: a pilot study. Pharmacotherapy. 1999;19: 787-793.
103.
103. Beyth RJ, Quinn L, Landefeld CS. A multicomponent intervention to prevent major bleeding complications in older patients receiving warfarin: a randomized, controlled trial. Ann Intern Med. 2000;133: 687-695.
104.
104. White RH, McCurdy SA, von Marensdorff H, et al. Home prothrombin time monitoring after the initiation of war far in therapy: a randomized, prospective study. Ann Intern Med. 1989;111: 730-737.
105.
105. Lucas FV, Duncan A, Jay R, et al. A novel whole blood capillary technique for measuring the prothrombin time. Am J Clin Pathol. 1987;88: 442-446.
106.
106. Oral Anticoagulation Monitoring Study Group. Prothrombin measurement using a patient self-testing system. Am J Clin Pathol. 2001;115: 280-287.
107.
107. Palacioz K. Home diagnostic tests. Pharmacist’s Letter. 2002;18(180615).
108.
108. Anderson DR, Harrison L, Hirsh J. Evaluation of a portable prothrombin time monitor for home use by patients who require long-term oral anticoagulant therapy. Arch Intern Med. 1993;153: 1441-1447.
109.
109. Marzinotto V, Monagle P, Chan A, et al. Capillary whole blood monitoring of oral anticoagulants in children in outpatient clinics and the home setting. Pediatr Cardiol. 2000;21: 347-352.
110.
110. Massicotte P, Marzinotto V, Vegh P, et al. Home monitoring of warfarin therapy in children with a whole blood prothrombin time monitor. JPediatr. 1995;127: 389-394.
111.
111. Cosmi B, Palareti G, Moia M, et al. Accuracy of a portable prothrombin time monitor (Coagucheck) in patients on chronic oral anticoagulant therapy: a prospective multicenter study. Thromb Res. 2000;100: 279-286.
112.
112. Cosmi B, Palareti G, Carpanedo M, et al. Assessment of patient capability to self-adjust oral anticoagulant dose: a multicenter study on home use of portable prothrombin time monitor (COAGUCHECK). Haematologica. 2000;85: 826-831.
113.
113. Lassen JF, Brandslund I, Antonsen S. International normalized ratio for prothrombin times in patients taking oral anticoagulants: critical difference and probability of significant change in consecutive measurements. Clin Chem. 1995;41: 444-447.
114.
114. Kulinna W, Ney D, Wenzel T, et al. The effect of self-monitoring the INR on quality of anticoagulation and quality of life. Semin Thromb Hemost. 1999;25: 123-126.
115.
115. Sawicki PT. A structured teaching and self-management program for patients receiving oral anticoagulation: a randomized controlled trial. Working Group for the Study of Patient Self-Management of Oral Anticoagulation. JAMA. 1999;281: 145-150.
116.
116. Ansell J, Holden A, Knapic N. Patient self-management of oral anticoagulation guided by capillary (fingerstick) whole blood prothrombin times. Arch Intern Med. 1989;49: 2509-2511.
117.
117. Ansell JE, Patel N, Ostrovsky D, et al. Long-term patient self-management of oral anticoagulation. Arch Intern Med. 1995;155: 2185-2189.
118.
118. Watzke HH, Forberg E, Svolba G, et al. A prospective controlled trial comparing weekly self-testing and self-dosing with the standard management of patients on stable oral anticoagulation. Thromb Haemost. 2000;83: 661-665.
119.
119. Fitzmaurice DA, Murray ET, Gee KM, et al. A randomised controlled trial of patient self management of oral anticoagulation treatment compared with primary care management. J Clin Pathol. 2002;55: 845-849.
120.
120. Ansell JE, Hamke AK, Holden A, et al. Cost effectiveness of monitoring warfarin therapy using standard versus capillary prothrombin times. Am J Clin Pathol. 1989;91: 587-589.
121.
121. Eldor A, Schwartz J. Self-management of oral anticoagulants with a whole blood prothrombin-time monitor in elderly patients with atrial fibrillation. Pathophysiol Haemost Thromb. 2002;32: 99-106.
122.
122. Expert Panel Report 2. Guidelines for the diagnosis and management of asthma. Apr. publication no. 97-4051. Bethesda, Md: National Asthma Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health; 1997.
123.
123. Reddel HK, Salmoe CM, Peat JK, et al. Which index of peak expiratory flow is most useful in the management of stable asthma? Am J Respir Crit Care Med. 1995;1995: 1320-1325.
124.
124. Morris NV, Abramson MJ, Strasser RP. Adequacy of control of asthma in a general practice: is maximum peak expiratory flow rate a valid index of asthma severity? Med J Aust. 1994; 160: 68-71.
125.
125. Jackson AC. Accuracy, reproducibility, and variability of portable peak flow meters. Chest. 1995;107: 648-651.
126.
126. Enright PL, Sherill DL, Lebowitz MD. Ambulatory monitoring of peak expiratory flow: reproducibility and quality control. Chest. 1995;107: 657-661.
128. Miller MR, Dickinson SA, Hitchings DJ. The accuracy of portable peak flow meters. Thorax. 1992;47: 904-909.
129.
129. Sly PD, Cahill P, Willet K, et al. Accuracy of mini peak flow meters in indicating changes in lung function in children with asthma. BMJ. 1994;308: 572-574.
130.
130. American Thoracic Society. Standardization of spirometry. Am J Respir Crit Care Med. 1995;152: 1107-1136.
131.
131. Scarfone RJ, Zorc JJ, Capraro GA. Patient self-management of acute asthma: adherence to national guidelines a decade later. Pediatrics. 2001;108: 1332-1338.
132.
132. Kolbe J, Vamos M, James F, et al. Assessment of practical knowledge of self-management of acute asthma. Chest. 1996;109: 86-90.
133.
133. Scarfone RJ, Capraro GA, Zorc JJ, et al. Demonstrated use of metered-dose inhalers and peak flow meters by children and adolescents with acute asthma exacerbations. Arch Pediatr Adolesc Med. 2002;156: 378-383.
134.
134. Verschelden P, Cartier A, L’Archeveque J, et al. Compliance with and accuracy of daily self-assessment of peak expiratory flows (PEF) in asthmatic subjects over a three month period. Eur Respir J. 1996;9: 880-885.
135.
135. Dawson KP, Van Asperen P, Higgins C, et al. An evaluation of the action plans of children with asthma. J Paediatr Child Health. 1995;31: 21-23.
136.
136. Leickly FE, Wade SL, Crain E, et al. Self-reported adherence management behavior, and barriers to care after an emergency department visit by inner city children with asthma. Pediatrics. 1998;101: 1-8.
137.
137. Warman KL, Silver EJ, McCourt MP, et al. How does home management of asthma exacerbations by parents of inner-city children differ from NHLBI guideline recommendations? Pediatrics. 1999;103: 422-427.
138.
138. Cote J, Cartier A, Malo JL, et al. Compliance with peak expiratory flow monitoring in home management of asthma. Chest. 1998;113: 968-972.
139.
139. Connolly CK. Falsely high PEFR due to acceleration in the mouth. BMJ. 1987;294: 285.
140.
140. Strayhorn V, Leeper K, Tolley E, et al. Elevation of peak expiratory flow by a “spitting” maneuver: measured with five peak flow meters. Chest. 1998;113: 1134-1136.
141.
141. Ross S, Cochran DP. Method for manipulating peak flow measurements producing falsely raised readings. Thorax. 2001;56: 500-501.
142.
142. Hyland ME, Kenyon CAP, Allen R, et al. Diary keeping in asthma: comparison of written and electronic methods. BMJ. 1993;306: 487-489.
143.
143. Malo JL, Trudeau C, Ghezzo H, et al. Do subjects investigated for occupational asthma through serial peak expiratory flow measurements falsify their results? J Allergy Clin Immunol. 1995;96: 601-607.
144.
144. Kamps AWA, Roorda RJ, Brand PLP. Peak flow diaries in childhood asthma are unreliable. Thorax. 2001;56: 180-182.
145.
145. Turner MO, Taylor D, Bennett R, et al. A randomized trial comparing peak expiratory flow and symptom self-management plans for patients with asthma attending a primary care clinic. Am J Respir Crit Care Med. 1998;157: 540-546.
146.
146. Jones KP, Mullee MA, Middleton M, et al. Peak flow based asthma self-management: a randomized controlled study in general practice. British Thoracic Society Research Committee. Thorax. 1995;50: 851-857.
147.
147. Drummond N, Abdalla M, Beattie JAG, et al. Effectiveness of routine self monitoring of peak flow in patients with asthma. BMJ. 1994;308: 564-567.
148.
148. Bheekie A, Syce JA, Weinberg EG. Peak expiratory flow rate and symptom self-monitoring of asthma initiated from community pharmacies. J Clin Pharm Ther. 2001;26: 287-296.
149.
149. Yoos HL, Kitzman H, McMullen A, et al. Symptoms monitoring in childhood asthma: a randomized clinical trial comparing peak expiratory flow rate with symptom monitoring. Ann Allergy Asthma Immunol. 2002;88: 283-291.
150.
150. Lahdensuo A, Haahtela T, Herrala J, et al. Randomized comparison of guided self management and traditional treatment of asthma over one year. BMJ. 1996;312: 748-752.
151.
151. Charlton I, Charlton G, Broomfield J, et al. Evaluation of peak flow and symptoms only self-management plans for control of asthma in general practice. BMJ. 1990;301: 1355-1359.
152.
152. Adams RJ, Boath K, Homan S, et al. A randomized trial of peak flow and symptoms based action plans in adults with moderate-to-severe asthma. Respirology. 2001;6: 297-214.
153.
153. Cowie RL, Shirley GR, Underwood MF, et al. The effect of a peak flow-based action plan in the prevention of exacerbations of asthma. Chest. 1997;112: 1534-1538.
154.
154. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;327: 307-310.
155.
155. Mengden T, Hernandez Medina RM, Beltran B, et al. Reliability of reporting self-measured blood pressure values by hypertensive patients. Am J Hypertens. 1998;11: 1413-1417.
156.
156. Ansell JE, Hughes R. Evolving models of warfarin management: anticoagulation clinics, patient self-monitoring, and patient self-management. Am Heart J. 1996;132: 1095-1100.
157.
157. Taborski U, Wittstamm FJ, Bernardo A. Cost-effectiveness of self-managed anticoagulant therapy in Germany. Semin Thromb Hemost. 1999;25: 103-107.
