Should patients stop inhaled corticosteroids and other prophylactic medications during the period of serial peak flow recordings?

I saw a patient in the clinic with a history of adult-onset asthma. I have asked her to keep a serial peak flow diary for six weeks [using the diary sheets on your website]. She is using beclomethasone MDI 200 micrograms bd. Does she need to stop this treatment until she has completed the six weeks of peak flow recordings? My understanding is that prophylactic treatment can make it difficult to diagnose occupational asthma. Could you please advise?

Occupational Asthma, Health Professional, 6/20/2006, 6/20/2006,

Preventative treatment, such as inhaled steroids, is likely to decrease the magnitude of any difference in peak flow between work days and rest days and this should be taken into account when making a diagnosis. The effect of the treatment should be constant on both work days and rest days. We do not recommend that treatment is stopped when completing serial peak flow readings. Relief medication, such as inhaled salbutamol, poses a different problem in that people often take more when their breathing is bad so the effect of the treatment can be different on work days and rest days. We ask patients to keep their treatment as consistent as possible during a record (eg. by taking a reliever inhaler as frequently on rest days as on work days) and to note down on the diary sheets the times and doses of the treatment taken.

6/20/2006

Thank you for your prompt and helpful advice!

6/20/2006